Middle Cerebral Artery Syndrome
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Middle Cerebral Artery Syndrome
Middle cerebral artery syndrome is a condition whereby the blood supply from the middle cerebral artery (MCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the lateral aspects of frontal, temporal and parietal lobes, the corona radiata, globus pallidus, caudate and putamen. The MCA is the most common site for the occurrence of ischemic stroke. Depending upon the location and severity of the occlusion, signs and symptoms may vary within the population affected with MCA syndrome. More distal blockages tend to produce milder deficits due to more extensive branching of the artery and less ischemic response. In contrast, the most proximal occlusions result in widespread effects that can lead to significant cerebral edema, increased intracranial pressure, loss of consciousness and could even be fatal. In such occasions, mannitol (osmotic diuretic) or hypertonic saline are given to draw fluid out of the edematous cerebrum to mi ...
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Middle Cerebral Artery
The middle cerebral artery (MCA) is one of the three major paired cerebral artery, cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex. It also supplies blood to the anterior temporal lobes and the insular cortex, insular cortices. The left and right MCAs rise from trifurcations of the internal carotid artery, internal carotid arteries and thus are connected to the anterior cerebral artery, anterior cerebral arteries and the posterior communicating artery, posterior communicating arteries, which connect to the posterior cerebral artery, posterior cerebral arteries. The MCAs are not considered a part of the Circle of Willis. Structure The middle cerebral artery divides into four segments, named by the region they supply as opposed to order of branching as the latter can be somewhat variable: *M1: The ''sphenoidal' ...
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Ataxia
Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicating dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum. Ataxia can be limited to one side of the body, which is referred to as hemiataxia. Several possible causes exist for these patterns of neurological dysfunction. Dystaxia is a mild degree of ataxia. Friedreich's ataxia has gait abnormality as the most commonly presented symptom. The word is from Greek α- negative prefix+ -τάξις rder= "lack of order". Types Cerebellar The term cerebellar ataxia is used to indicate ataxia due to dysfunction of the cerebellum. The cerebellum is responsible for integrating a significant amount of neural information that is used to coordinate smoothly ongoing movements and to participate in motor planning. Although a ...
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Head CT
Computed tomography of the head uses a series of X-rays in a CT scan of the head taken from many different directions; the resulting data is transformed into a series of cross sections of the brain using a computer program. CT images of the head are used to investigate and diagnose brain injuries and other neurological conditions, as well as other conditions involving the skull or sinuses; it used to guide some brain surgery procedures as well. CT scans expose the person getting them to ionizing radiation which has a risk of eventually causing cancer; some people have allergic reactions to contrast agents that are used in some CT procedures. Uses Computed tomography (CT) has become the diagnostic modality of choice for head trauma due to its accuracy, reliability, safety, and wide availability. The changes in microcirculation, impaired auto-regulation, cerebral edema, and axonal injury start as soon as head injury occurs and manifest as clinical, biochemical, and radiological chan ...
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Homonymous Hemianopsia
Hemianopsia, or hemianopia, is a visual field loss on the left or right side of the vertical midline. It can affect one eye but usually affects both eyes. Homonymous hemianopsia (or homonymous hemianopia) is hemianopic visual field loss on the same side of both eyes. Homonymous hemianopsia occurs because the right half of the brain has visual pathways for the left hemifield of both eyes, and the left half of the brain has visual pathways for the right hemifield of both eyes. When one of these pathways is damaged, the corresponding visual field is lost. Signs and symptoms Paris as seen with right homonymous hemianopsia Mobility can be difficult for people with homonymous hemianopsia. "Patients frequently complain of bumping into obstacles on the side of the field loss, thereby bruising their arms and legs." People with homonymous hemianopsia often experience discomfort in crowds. "A patient with this condition may be unaware of what he or she cannot see and frequently bumps ...
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Déviation Conjuguée
Déviation conjuguée, also termed conjugate eye deviation (CED) or ipsilesional gaze shift, is a medical sign indicating brain damage (e.g. a stroke in the middle cerebral artery The middle cerebral artery (MCA) is one of the three major paired cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches and projects to ma ...), wherein the pupils of the eye tend to move toward the side of the body where the lesion is located. The symptom was described by Swiss neurologist Jean-Louis Prévost in 1868. References Medical signs {{med-sign-stub ...
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Apraxia
Apraxia is a motor disorder caused by damage to the brain (specifically the posterior parietal cortex or corpus callosum), which causes difficulty with motor planning to perform tasks or movements. The nature of the damage determines the disorder's severity, and the absence of sensory loss or paralysis helps to explain the level of difficulty. Children may be born with apraxia; its cause is unknown, and symptoms are usually noticed in the early stages of development. Apraxia occurring later in life, known as ''acquired apraxia'', is typically caused by traumatic brain injury, stroke, dementia, Alzheimer's disease, brain tumor, or other neurodegenerative disorders. The multiple types of apraxia are categorized by the specific ability and/or body part affected. The term "apraxia" comes from the Greek ἀ- ''a-'' ("without") and πρᾶξις ''praxis'' ("action"). Types The several types of apraxia include: * Apraxia of speech (AOS) is having difficulty planning and coordinating the ...
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Anosognosia
Anosognosia is a condition in which a person with a disability is cognitively unaware of having it due to an underlying physical or psychological (e.g., PTSD, Stockholm syndrome, schizophrenia, bipolar disorder, dementia) condition. Anosognosia can result from ''physiological damage'' to brain structures, typically to the parietal lobe or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere, and is thus a neuropsychiatric disorder. A deficit of self-awareness, it was first named by the neurologist Joseph Babinski in 1914. Phenomenologically, anosognosia has similarities to denial, which is a psychological defense mechanism; attempts have been made at a unified explanation. Anosognosia is sometimes accompanied by asomatognosia, a form of neglect in which patients deny ownership of body parts such as their limbs. The term is from Ancient Greek ἀ- ''a-'', 'without', νόσος ''nosos'', 'disease' and γνῶσις ''gnōsis'', 'knowledge'. It is als ...
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Hemispatial Neglect
Hemispatial neglect is a neuropsychological condition in which, after damage to one hemisphere of the brain (e.g. after a stroke), a deficit in attention and awareness towards the side of space opposite brain damage (contralesional space) is observed. It is defined by the inability of a person to process and perceive stimuli towards the contralesional side of the body or environment. Hemispatial neglect is very commonly contralateral to the damaged hemisphere, but instances of ipsilesional neglect (on the same side as the lesion) have been reported. Presentation Hemispatial neglect results most commonly from strokes and brain unilateral injury to the right cerebral hemisphere, with rates in the critical stage of up to 80% causing visual neglect of the left-hand side of space. Neglect is often produced by massive strokes in the middle cerebral artery region and is variegated, so that most sufferers do not exhibit all of the syndrome's traits. Right-sided spatial neglect is rare bec ...
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Global Aphasia
Global aphasia is a severe form of nonfluent aphasia, caused by damage to the left side of the brain, that affects Language processing in the brain, receptive and Expressive language disorder, expressive language skills (needed for both written and oral language) as well as auditory and visual comprehension.Brookshire, R. H. (2007). Introduction to neurogenic communication disorders (Seventh edition.). St. Louis, Mo.: Mosby Elsevier. Acquired impairments of communicative abilities are present across all language modalities, impacting language production, comprehension, and repetition.Goodglass, H., and Kaplan, E. (1983). The assessment of aphasia and related disorders. Philadelphia: Lea and Febiger. Patients with global aphasia may be able to verbalize a few short utterances and use non-word neologisms,Manasco, H. M. (2014). Introduction to Neurogenic Communication Disorders. Burlington, MA: Jones & Barlett Learning. but their overall production ability is limited. Their ability t ...
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Receptive Aphasia
Wernicke's aphasia, also known as receptive aphasia, sensory aphasia or posterior aphasia, is a type of aphasia in which individuals have difficulty understanding written and spoken language. Patients with Wernicke's aphasia demonstrate fluent speech, which is characterized by typical speech rate, intact syntactic abilities and effortless speech output. Writing often reflects speech in that it tends to lack content or meaning. In most cases, motor deficits (i.e. hemiparesis) do not occur in individuals with Wernicke's aphasia. Therefore, they may produce a large amount of speech without much meaning. Individuals with Wernicke's aphasia are typically unaware of their errors in speech and do not realize their speech may lack meaning. They typically remain unaware of even their most profound language deficits. Like many acquired language disorders, Wernicke's aphasia can be experienced in many different ways and to many different degrees. Patients diagnosed with Wernicke's aphasia c ...
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Broca's Area
Broca's area, or the Broca area (, also , ), is a region in the frontal lobe of the dominant Cerebral hemisphere, hemisphere, usually the left, of the Human brain, brain with functions linked to speech production. Language processing in the brain, Language processing has been linked to Broca's area since Pierre Paul Broca reported impairments in two patients. They had lost the ability to speak after injury to the posterior inferior frontal gyrus (pars triangularis) (BA45) of the brain. Since then, the approximate region he identified has become known as Broca's area, and the deficit in language production as Broca's aphasia, also called expressive aphasia. Broca's area is now typically defined in terms of the pars opercularis and pars triangularis of the inferior frontal gyrus, represented in Korbinian Brodmann, Brodmann's Brodmann area, cytoarchitectonic map as Brodmann area 44 and Brodmann area 45 of the dominant hemisphere. Functional magnetic resonance imaging (fMRI) has show ...
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Aphasia
Aphasia is an inability to comprehend or formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in the Global North. Aphasia can also be the result of brain tumors, brain infections, or neurodegenerative diseases (such as dementias). To be diagnosed with aphasia, a person's speech or language must be significantly impaired in one (or more) of the four aspects of communication following acquired brain injury. Alternatively, in the case of progressive aphasia, it must have significantly declined over a short period of time. The four aspects of communication are auditory comprehension, verbal expression, reading and writing, and functional communication. The difficulties of people with aphasia can range from occasional trouble finding words, to losing the ability to speak, read, or write; intelligence, however, is unaffected. Expressive lan ...
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