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Hoorcolleges vak Neurorevalidatie minor neurorevalidatie HAN $6.10
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Hoorcolleges vak Neurorevalidatie minor neurorevalidatie HAN

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  • October 5, 2023
  • 13
  • 2022/2023
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HC Neurorevalidatie

HC 1 CVA

Cerebro Vasculair Accident
 “Ongeluk van de bloedvaten in de hersenen”
 Herseninfarct = ischeamisch
 Hersenbloeding = hemorragisc
 Transient Ischeamic Attack = TIA
 Gevolg = NAH (niet-aangeboren hersenletsel)

Ischeamisch CVA
 Afsluiting bloedvat
o Trombus / embolie
o Artherosclerose (dichtslibben)
 Hypoxie na afsluiting (verlaagde zuurstof)
o Hypoperfusie (verlaagde bloedsomloop)
 Corticaal infarct
o Bloedvoorziening van grote hersenen
 Subcorticaal infarct
o Lagere niveaus hersenen
 Lacunair infarct
o Kleine bloedvaten, minder schade
 Waterscheidingsinfarct
o Gebied slagaders overlopen in aderen
o Gebrek bloedsomloop

Behandeling Ischeamisch CVA
 Tijd = afsterving hersenweefsel
 Trombolyse (4,5 uur na ontstaan uitval)  bloedverdunners
in vat
 Trombectomie (6 uur ontstaan uitval)  met katheter

Hemorragisch CVA (hersenbloeding)
 Doorbraak bloedvat
o Hypertensie
o Aneurysma (zwakke plek)
o Vaatmalformatie
 Intercerebrale bloeding
 Subarachnoïde bloeding
 Subdurale bloeding
 Epidurale bloeding

, Behandeling Hemorragisch CVA
 Afwachten
 Medicatie staken
 Bloeddruk verlagen
 Operatie
o Clipping
o Coiling
o Schedel lichten
 Drain
o Extern/intern

Transient Ischeamic Attack = TIA
 Tijdelijk van aard
 Geen restklachten
 Verkeerde diagnose bij onzichtbare gevolgen?

Cijfers beroerte Nederland
 40.000 beroerte, 110 per dag
o 80% infarct 20% bloeding
 360.000 leven met gevolgen
 2 van de 3 ziekenhuis patiënten kunnen 3 maanden na opname weer zelfstandig
thuis functioneren
 Kosten in 2017 > 1,5 miljard euro

De hersenen
 Bepaalde gebieden
 Maar een samenhangend geheel van netwerken
 Grote hersenen (cerebrum)
o Frontale kwab
o Pariëtale kwab
o Occipitale kwab
o Temporale kwab
 Kleine hersenen (cerebellum)
 Hersenstam
o Pons
o Verlengde merg
o Ruggenmerg

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