stroke and vascular dementia

Case Study – Meet Harry Use to discuss stroke and vascular dementia. Harry (52 yrs) presented to a hospital emergency department 10 days ago with a left facial droop and left arm weakness. MRI brain showed that Harry suffered a right middle cerebral artery (MCA) territory stroke, beginning at the upper aspect of the temporal operculum and extending postero-superiorly, with scattered cortical and subcortical lesions. He also suffered a left posterior cerebral artery (PCA) stroke evident by cortical and subcortical infarction in the left occipital pole laterally. Substantial chronic areas of infarction were also seen in the left pons towards its anterior aspect superiorly. White matter gliosis was found surrounding the upper aspect of the lateral ventricles and scattered in the frontal and parietal lobes. Multiple areas of critical stenosis or occlusion were also found throughout the brain. Nursing progress notes throughout his current admission have noted Harry to ambulate independently, was continent and able to toilet independently, became ‘lost’ and wandered into the car park 2 days after his stroke, had an episode of confusion and a fall out of bed about a week after his stroke (no injury sustained). Harry has Type II diabetes mellitus, and high blood pressure. He is a smoker. Stroke nurse progress notes noted a history of noncompliance with medication and monitoring of blood sugar levels, due to Harry’s reporting an inability to afford his medications and strips for monitoring of blood sugar levels. Occupational therapy assessment noted reduced upper limb strength, but the upper limb was functional in terms of personal activities of daily living. Speech pathology assessment noted mild dysarthria, impulsivity, and appropriate ability to follow commands. He was distractible and/or fatigued. Physiotherapy progress notes stated that from a physiotherapy perspective, Harry was safe for discharge. You speak with Harry’s daughter, Irene. Irene reported a 2-3 year decline in Harry’s memory, diet, and compliance with his medication. Describe the two main types of stroke (Ischemic and Hemorrhagic)? PSY3CNN Case Study – Harry, Stroke, Vascular Dementia 2 What areas of the brain do the middle cerebral arteries (MCA) supply? What areas of the brain do the posterior cerebral arteries (PCA) supply? What are some common clinical deficits of a MCA stroke? What are some common clinical deficits of a PCA stroke? What is Vascular Dementia? What are some common risk factors for Stroke/Vascular Dementia? What are some common cognitive deficits of Vascular Dementia?