Stroke 346241

STROKE: Basal Ganglia Bleed

Anatomy Of The Basal Ganglia

• Basal ganglia is located deep with each of cerebral hemisphere in the telencephalon region of the brain. • The components of the basal ganglia are: 1. The Caudate, 2. The Putamen 3. The Globus Pallidus, 4. The Subthalamic Nucleus 5. The Substantia Nigra

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The basal ganglia receive input from the cerebral cortex and provide output back to motor areas of the cerebralcortex via neural connection with nuclei of the thalamus.

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Major function of the basal ganglia:

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i.

Suppres unwanted movements

ii.

Help initiate and terminate movements of the body

iii.

Regulate muscle tone

The basal ganglia also influence many aspects of cortical function such as sensory, limbic, cognitive and linguistic function.

Basal Ganglia Haemorrhage (bleeding)

• A basal ganglia haemorrhage is bleeding from blood vessels in an area of the brain that responsible for the body movements, sensation, speech and personality. • The area of the basal ganglia is the part of the brain most frequently affected by haemorrhages. • A brain haemorrhage causes blood to accumulate inside the brain, compressing and damaging brain tissue. • Usually artery in the basal ganglia bursts after being damaged due to high blood pressure.

Pathophysiology Of the Stroke due to Basal Ganglia Bleed Presipitating factor: Hypertantion

Vasoconstriction Blockage of the blood vessels Lack of oxygen and nutrient supply Altered and decreased

Predisposing factors: i. Sedentary lifestyle ii. Diet iii. Age iv. Sex v. Heredity vi. Self-medication

Intracerebral haemorrhage (bleeding) Blood irritates the nerves and the tissues

Blood clot formation

Pressure and brain compression •

Pain and vomiting; parts of the brain will shut down; decreased LOC

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• • •

Changes in movements (ataxia) Muscle weakness (difficulty in swallowing, smiling and talking) Decreased cognitive function Headache, nausea and vomiting Personality changes: change in judgement, confused, difficulty in understanding what is happening around. Inappropriate emotional responses

Clinical presentation of the stroke due to the basal ganglia bleed I. Changes in the body movement:

III. Unconsciousness, nausea, vomiting and headache

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Rigid, stiff movements

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Movement loss

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Tremors

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Ataxia

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Difficulty understanding

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Difficulty swallowing

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Frustation

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Difficulty in smiling or speaking

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Anxious

•

Lack of motivation

II. Cognitive impairment:

IV. Personality Changes:

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Ability to make decisions

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Loss of interest in any activities

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Memory

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Crying for no reason

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Language

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Laugh for no reason

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Attantion

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Depression

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Anger

Doctor and Physiotherapist Management for the stroke due to basal ganglia bleed 1.

Brain imaging – CT scan ca.n show fresh blood in the skull.

2.

Pain medication,

3.

Stabilizing vital signs,

4.

Pressure inside the head.

5.

Surgery to removing any blood to relieve pressure,

6.

A shunt operation to drain the system

i.

Strengthening and exercise

ii.

ive (PROM) and active (AROM) exercise

iii. Improving iv. Balance v.

balance and mobility

and sensory organization

Locomotor training

vi. Adative

vii.Gait

equipment: walking aids, wheelchair

training

References 1.

http://www.theuniversityhospital.com/stroke/types.htm

2.

http://www.livestrong.com/article/146462-basal-ganglia-strokesymptoms/

3.

http://stroke.ahajournals.org/content/20/7/876.short

4.

http://www.wisegeek.com/what-is-the-caudate-nucleus.htm

5.

http://www.wisegeek.com/what-is-the-substantia-nigra.htm

6.

http://www.wisegeek.com/what-is-a-basal-ganglia-hemorrhage.htm

7.

http://byebyedoctor.com/basal-ganglia-stroke/

8.

http://www.atrainceu.com/pdf/62_Stroke.pdf

9.

http://www.livestrong.com/article/393445-an-exercise-for-strokevictims/

10. http://www.livestrong.com/article/430227-rehabilitation-of-the-

foot-due-to-a-stroke/

11.

http://www.aifo.it/english/resources/online/books/cbr/strokecarraro/6walking.pdf

12.

http://repub.eur.nl/res/pub/13555/081022_Janssen,%20Wilhel mus%20Gerardus%20Maria.pdf