SP 128: PI Communication and Swallowing Disorders

• Cerebrovascular Disease (Stroke)

  • condition in the brain characterized by altered blood flow, ultimately leading to tissue infarction
  • ischemic and hemorrhagic
• Ischemic stroke is cause by occlusive vascular disease (usually by embolism or thrombosis)
• Hemorrhagic Stroke

  • hypertension induced blood vessel weakening
  • genetic predisposition to develop aneurysm
• Stroke Morphologic Changes

  • First 6 hours: brain tissue are normal
  • 2-10 days: pale, soft, swollen, gelatinous, friable
  • in a few weeks: liquefaction
• Stroke clinical manifestations

  • Neurologic deficits determined by anatomic distributions of the damage rather than underlying cause
• Alzheimer's Disease (Ethno-pathogenesis)

  • progressive disease that involves accumulation of A-beta and Tau proteins in specific regions
  • leading to deposits of amyloid plaques and neurofibrillary tangles
• Alzheimer's Morphologic Changes

  • Cortical atrophy with compensatory ventricular enlargement
  • plaque and tangle deposition
  • neuronal loss
  • reactive gliosis
• Alzheimer's Clinical Manifestations

  • Deficits in memory, visuospatial orientation, judgment, personality, language, motor skills
  • Protein accumulations lead to the morphologic changes in the brain
  • smaller gyri with deeper sulci
• Congenital Anomalies

  • Anatomic deficits that are present at birth but some manifestations are apparent in later years
  • genetic, environmental, or both
• Those born with anomalies might represent the less serious developmental failure in early embryogenesis
• Reason of disruption of organ development

  • Defects in single gene or chromosome
  • Fetal Compression
  • small uterus/multiple fetuses (twins)
  • timing of prenatal teratogenic
• Timing of the Prenatal teratogenic

  • first 3 weeks
  • either mild or severe
  • can survive or not
  • 3rd to 9th week
  • susceptible to teratogens because this is the time that organs are beginning to develop
• Trisomy 21 (Down Syndrome)

  • Increase in incidence with increasing maternal age
  • Younger 20: 1 in 1500 live births
  • Older than 45: 1 in 25
• Down Syndrome clinical Manifestations

  • flat facial profile, oblique palpebral fissures, and epicanthic folds
  • ear canal stenosis
  • more than 40: develop neuropathic changes of Alzheimer's disease