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NEUROLOGICAL

DISORDERSPresented by:

Christian B. Caperol

Jennelyn F. Lumbre

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Alternative names: Cerebrovascular

accident (CVA), Brain attack

STROKE

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Definition

A strokeis a medical emergencyin

which the blood supplyto any portion

ofthe brainis interruptedorreduced.

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Etiology

Thrombosis

Embolism

Hemorrhage

Other causes: cerebral artery spasm,hypercoagulable states

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2majortypes of stroke

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Ischemic stoke Hemorrhagic Stoke

occurs whenthe

arteries tothe brainarenarrowedorblocked, causingseverelyreduced

bloodflow.

Thrombotic stroke

Embolic stroke

occurs when a blood

vessel inthe brain leaksorruptures.

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Clinical manifestations

Generalizedfindings: Headache

Vomiting

Seizures

Changein mentalstatus

Fever

Specific deficitsafter stroke: Hemiparesis (weakness

of one side of the body)

Hemiplegia (paralysis ofone side of the body)

Aphasia

Dysarthria

Dysplegia

Dysphagia

Apraxia

Unilateral neglect

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The symptoms of a stroke are dependant

on what portion of the brain is damage.

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Management

ISCHEMIC STROKE

Tissue plasminogen activator(tPA) usedtodissolvetheclot and unblockthe

artery.

Anticoagulants/antiplatelets

Angioplasty and stenting

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Contd..

HEMORRHAGIC STROKE

Surgery is often required to removepooled blood from the brain and torepair damaged blood vessels.

Prevention: An obstruction is introduced to prevent

rupture and bleeding of aneurysms andarteriovenous malformations (AVM). Surgical Intervention Endovascular Procedures

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BELLS PALSY

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DEFINITION

Bell's palsyis a conditionin which there

is paralysis ofthe muscles oftheface,

typicallyonone side. Itis usuallytemporary with most people making a

full recovery within2-3 months. It

comes on suddenly, andthecauseis

unknown.

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Etiology

Causeis unknown, butthe mechanismis presumably swellingofthe 7thcranial (facial)nervedueto animmuneorviral disorder. Recentevidence suggests herpes simplex virusinfection. Thenerveis compressed,resultinginischemia and paresis,

becausethenerve passes through anarrow opening (internal acousticmeatus)inthetemporal bone.

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Signs and symptoms

Distortionofface.

Numbness offace andtongue.

Overflow oftears downthecheekfromkeratitis caused bydryingofcornea andlackof blinkreflex.

Decreasedtearproductionthat may

predisposetoinfection.

Speech difficulty secondarytofacialparalysis.

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Medical management:

Administersteroidtherapy, as ordered. (Mayreduceinflammation andedema andrestorenormal bloodcirculationtothenerve.)

Provideforpainrelief with analgesics andlocal applicationof heat.

Facial massage may be prescribedto helpmaintain muscletone.

Surgical intervention may benecessary.>Decompressionoffacial nerve.

>Surgical correctionofeyeliddeformities.

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TRIGEMINAL NEURALGIA

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Definition