Posts Tagged basal ganglia
What happens when a stroke occurs in the basal ganglia? Learn about its symptoms, treatment, and how to prevent strokes from occurring.
A stroke is a medical emergency that can occur when the blood supply to part of the brain is cut off.
A stroke can also occur when a blood vessel in the brain bursts and spills blood into the spaces between and around the brain cells.
Contents of this article:
What is a basal ganglia stroke?
Blood carries oxygen to the brain. When blood flow to an area of the brain is disrupted or stopped, the brain can’t get enough oxygen. Brain cells in the affected area are injured and die.
Deep in the center of the brain lies the message center of the brain, an area of cells called the basal ganglia. These cells work together to control the following:
- Muscle control
- Some aspects of thinking
A basal ganglia stroke is particularly dangerous because this area of the brain is so important.
Causes and types of stroke
There are several different kinds of strokes, all with different causes. The three main types of strokes are as follow.
This common stroke happens when a blood vessel carrying blood to the brain is blocked by a blood clot, making it impossible for blood to reach the brain. Over 80 percent of all strokes are ischemic.
An ischemic basal ganglia stroke may occur when a blood vessel fed by the middle cerebral artery has a clot.
This less common type of stroke accounts for almost 40 percent of all stroke deaths, according to the National Stroke Association. This type of stroke happens when blood spills from a burst or leaky blood vessel into the tissue around the brain. This creates swelling and pressure that damages the brain.
The basal ganglia is one of the areas most commonly affected by hemorrhagic strokes due to uncontrolled hypertension.
TIA, or transient ischemic attack
These events are often described as mini strokes. More accurately, stroke-like symptoms occur for less than 24 hours and resolve with no lasting damage. These events may be a warning sign of a stroke.
Symptoms of a basal ganglia stroke
Strokes have a group of common symptoms. Knowing these signs and symptoms can save a life. However, a basal ganglia stroke has some unique symptoms that may make it harder to identify than other types of stroke.
Common stroke symptoms include:
There are many different stroke symptoms, some common and some unique to basal ganglia strokes.
- Sudden numbness or weakness in the face, arm, or leg on one side of the body
- Sudden confusion, trouble communicating, or understanding
- Severe headache
- Trouble walking and loss of balance and coordination
- Sudden trouble seeing in one or both eyes
- Droopy, uneven smile
A basal ganglia stroke may also cause those symptoms, but can cause other symptoms that include:
- Weak or very stiff muscles that restrict movement
- Difficulty swallowing
- Loss of awareness of one side of the body
- Severe apathy
- Personality changes
Anyone who notices these symptoms in themselves or someone else, they should seek immediate medical attention.
Basal ganglia stroke treatment
Treatment for a basal ganglia stroke depends on what kind of stroke occurred and how quickly medical attention was received. In select cases, people with ischemic basal ganglia strokes may receive a drug that will break up blood clots.
Those with hemorrhagic basal ganglia strokes may need to have surgery. Increased pressure may need to be relieved surgically. In certain cases, a surgeon can insert a small device into the opened artery to close it. Larger bleeds may need more significant surgery.
A stroke of any kind can be life-threatening. However, if medical intervention is sought quickly, a patient will be more likely to make a better recovery.
Recovering from a stroke can be a lifelong process. The outlook after a basal ganglia stroke depends mainly on how much damage the brain suffered. If the basal ganglia is only mildly damaged, a better recovery is more likely.
One study found that patients with damage in this area of the brain don’t respond as well to rehabilitation efforts as patients with damage in other areas of the brain.
Lasting effects from a basal ganglia stroke can include:
- Changes in sensation: People recovering from a basal ganglia stroke may have a hard time feeling or knowing when they are touched. This can make it hard to tell how the body is moving and regain control of these movements.
- Loss of movement: Like all strokes, basal ganglia strokes may cause lasting muscle weakness, particularly on the left side.
- Difficulty starting, stopping, or sustaining movement: Damage to this area of the brain makes regulating movement difficult.
- Changes in vision and eye movement: A stroke may take away a large part of the person’s visual field. After a stroke, it can be difficult to look up or control the way the eyes move.
- Changes in personality: The stroke may make a person laugh or cry at times that don’t make sense. Many stroke victims also deal with depression after a stroke.
- Change in judgment: Confusion is common after a stroke, which makes it hard to make decisions and think logically.
- Changes in speech: A person recovering from a stroke may mix up words, forget words altogether, or make up words when speaking.
Stroke risk factors and prevention
Knowing the risk factors could help prevent any stroke. Strokes are most likely in older African-American, Alaska Native, and Native American adults. However, people of all ages and ethnicities are at risk. Other medical risk factors include:
- Family or personal history of stroke
- History of TIA
- High blood pressure
- Atrial fibrillation – when the upper chambers of the heart contract in an irregular way
- High cholesterol
- Carotid artery disease – a narrowing of the arteries in the neck that supply blood to the brain
While no one can totally prevent all of the risk factors, there are many ways to decrease stroke risk. Stroke risk can be decreased by:
- Maintaining a healthy weight through diet and exercise
- Controlling blood pressure
- Managing diabetes
- Quitting smoking
- Limiting alcohol use
There is growing interest in the therapeutic potential of marijuana (cannabis) and cannabinoid-based chemicals within the medical community and, particularly, for neurological conditions. This interest is driven both by changes in the legal status of cannabis in many areas and increasing research into the roles of endocannabinoids within the central nervous system and their potential as symptomatic and/or neuroprotective therapies. We review basic science as well as preclinical and clinical studies on the therapeutic potential of cannabinoids specifically as it relates to movement disorders. The pharmacology of cannabis is complex, with over 60 neuroactive chemicals identified to date. The endocannabinoid system modulates neurotransmission involved in motor function, particularly within the basal ganglia. Preclinical research in animal models of several movement disorders have shown variable evidence for symptomatic benefits, but more consistently suggest potential neuroprotective effects in several animal models of Parkinson’s (PD) and Huntington’s disease (HD). Clinical observations and clinical trials of cannabinoid-based therapies suggests a possible benefit of cannabinoids for tics and probably no benefit for tremor in multiple sclerosis or dyskinesias or motor symptoms in PD. Data are insufficient to draw conclusions regarding HD, dystonia, or ataxia and nonexistent for myoclonus or RLS. Despite the widespread publicity about the medical benefits of cannabinoids, further preclinical and clinical research is needed to better characterize the pharmacological, physiological, and therapeutic effects of this class of drugs in movement disorders.
Spasticity as a motor disorder is a result of injury to the brain and/or the spinal cord. Its gradual development is caused by a group of neurophysiologic mechanisms emerging after central nervous system (CNS) injury.
Loss of descending inhibitory (reticulospinal) inﬂuences leads to exaggerated excitability of dynamic gamma neurons and alpha motor neurons. Other spinal tracts such as the vestibulospinal and rubrospinal tracts become more active. Essentially, spasticity can result from injury to the cortex, basal ganglia, thalamus, brainstem, cerebellum, central white matter, or spinal cord.
It affects patients with cerebrovascular episodes, traumatic brain injury, spinal cord injury, multiple sclerosis (MS), and others. (1)
In order to study “spasticity” and provide the right treatment at the right time, we must first analyze all aspects of the phenomenon, such as:
a) The nature of spasticity, b) its differentiation from other clinical syndromes of muscle tone disorders, c) its different development according to the site and degree of the injury, d) the modification it shows in time, e) its changes throughout the day and during sleep, f) its coexistence with other symptoms such as pain, and g) its changes in intensity due to external and internal sensory stimuli.
Definition and clinical particularities of spasticity
In the traditional sense of the term, James Lance, MD, described spasticity in 1980 as “a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexitability of the stretch reflex as one component of the upper motor neurone syndrome.” (2)
Continue —> Managing spasticity with a focus on rehabilitation.