Stroke and Brain Injury Week 1

Stroke and Brain Injury

• Temporary or permanent effects from a stroke include motor, perceptual, cognitive, sensory, and emotional disturbances.
• A thrombotic stroke occurs when a blood clot blocks blood flow to the brain, depriving brain tissue of oxygen.
• An embolic stroke involves a fatty plaque or blood clot that travels from elsewhere in the body and obstructs a brain artery.
• A cerebral hemorrhage results from a break in a blood vessel in the brain, causing bleeding.
• Contributing factors for stroke include age, stress, past medical history, and smoking.
• Other risk factors consist of abdominal obesity, high blood pressure, diabetes, heart disease, and smoking.
• CVA (cerebrovascular accident) is a non-temporary blood flow interruption in the brain, leading to likely permanent neurological deficits.
• TIA (transient ischemic attack) is a temporary interruption of blood flow, resulting in no permanent deficits.
• Post-CVA presentations vary by hemisphere; left-sided strokes lead to right-side paralysis and communication issues; right-sided strokes cause left-side paralysis and impulsive behavior.
• Common post-stroke effects include vision problems, dysphagia, impaired memory, facial control loss, incontinence, and emotional disturbances.
• Preventing CVA recurrence may involve surgery, controlling hypertension, anticoagulant medication, treating predisposing conditions, and early initiation of therapy.
• Recognizing stroke through the acronym F.A.S.T.: Face drooping, Arm weakness, Speech difficulties, and Time to call emergency services.

Acquired Brain Injury

• Acquired brain injuries can occur due to head trauma and typically affect individuals aged 15-30.
• Signs include subarachnoid bleeding, increased intracranial pressure, and brain cell death.
• Symptoms may present as vomiting, confusion, drowsiness, paralysis, pupil dilation, and mood changes.
• Long-term effects include paralysis, sensory disturbances, aphasia, cognitive issues, and emotional disturbances.

Effects on Exercise Response

• Aerobic capacity decreases significantly, and only 24% achieve normal heart rate levels.
• Individuals experience quicker fatigue and decreased endurance, impacting functionality.

Alzheimer's Disease

• A progressive neurological disorder leading to cognitive impairments and is the most common cause of dementia.
• Nerve cells degenerating results in intellectual decline and affects approximately 1 in 11 over age 65.
• Symptoms include cognitive decline, balance issues, communication difficulty, mood changes, and anxiety.
• Disease progression consists of forgetfulness, confusion, severe cognitive impairments, and agitation.

Sundowning

• Characterized by increased confusion and agitation in the late day, impacting quality of life.
• Causes include fatigue, low lighting, sleep disruption, and limited afternoon activity.
• Responses involve ensuring rest, avoiding overstimulation, and maintaining a structured routine.

Effects of Physical Exercise in Alzheimer's

• Regular exercise can improve physical fitness, mood, and cognitive function, slowing cognitive decline.

Parkinson's Disease

• A progressive disorder influenced by dopamine deficiency, affecting approximately 1.5 million people.
• Risk factors include age (40-70), head injuries, genetic predisposition, and certain occupational exposures.
• Signs include rigidity, shuffling gait, masked facial expressions, resting tremors, and speech changes.
• Progressive stages from one-sided symptoms to wheelchair-bound conditions are identified in the Hoehn and Yahr scale.

Concussion

• A form of traumatic brain injury caused by external force, leading to rapid movement of the brain.
• Symptoms manifest as headaches, confusion, dizziness, amnesia, and potential neck pain.
• Recovery guidelines have evolved from prolonged rest to gradual cognitive stimulation.
• Prolonged effects may include mood changes, sleep disturbances, and balance issues.

Neurological Disorders

• Common disorders include Multiple Sclerosis (MS), Parkinson's disease, Huntington's disease, ALS, CVA, SCI, and ABI.
• MS is characterized by demyelination leading to various physical and cognitive impairments; it has no identifiable cause.
• Huntington's disease is hereditary, causing brain region-specific cell death, leading to uncontrolled movement and cognitive decline.

ALS (Amyotrophic Lateral Sclerosis)

• Characterized by motor neuron degeneration, impacting voluntary muscle control.
• Affects primarily individuals aged 40-70 years; 3,000 Canadians currently live with ALS.
• Symptoms progress from muscle weakness to complete loss of movement, with little cognitive function loss.

Multiple Sclerosis (MS)

• The highest MS rate is found in Canada, affecting over 90,000 people.
• MS types include relapsing-remitting, primary progressive, secondary progressive, and progressive-relapsing.
• Treatment focuses on managing symptoms and preventing exacerbations using medications and therapies.