cva
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Definition:
“CVA or stroke or brain attack is
sudden loss of neurological function
caused by an interruption of the
blood flow to the brain.” (O’Sullivan,
S. B., 2007)
Anatomy of the brain
Function:
The cortex: thinking and voluntary
movements.
The brain stem: breathing and sleep
are controlled here.
The basal ganglia: coordinate
messages between multiple other
brain areas.
The cerebellum: coordination and
balance.
http://www.webmd.com/brain/picture-of-the-brain
Lobes of the brain
The Frontal Lobe: reasoning, planning, part of speech, problem solving, judgment & motor function.
The Parietal lobe: perception of stimuli, movement, orientation, recognition
The Temporal Lobe: perception and recognition of auditory stimulation, memory and speech
The Occipital Lobe:
visual processing
http://www.webmd.com/brain/picture-of-the-brain
Left hemisphere Right Hemisphere
1. Sequential analysis:
systematic, logical
interpretation of information.
2. Interpretation and production
of symbolic information:
maths, language, abstraction
and reasoning.
3. Memory stored in language
format.
1. Holistic functioning:
processing multisensory input
simultaneously to provide
“holistic’ picture of one
environment.
2. Visual spatial skill
3. Dancing and gymnastic
4. Memory is stored in auditory,
visual and spatial modalities
http://www.thethinkingbusiness.com/brain_zone/brain-tour/brain-hemispheres
What is neuroplasticity?
Define as “ the ability of the brain to change and
repair itself.”
Mechanism of neuroplasticity?
Neuroanatomical Neurochemical
Neuroreceptive
changes Physical Rehabilitation: Chapter 13 Strategies to improve motor function, page
483
(i) Spontaneous recovery
Occur immediately after the
insult.
It influenced by diaschisis -
the return to function of
undamaged parts of the
brain with the resolution of
temporary blocking factors.
(i.e., shock, edema,
decreased blood flow,
decrease glucose utilization).
(ii) function-
induced recovery
The neural
organization that
occurs as a result
of increased use of
involved body
segments in
behaviorally
relevant tasks.
Physical Rehabilitation: Chapter 13 Strategies to improve motor function, page 483
Types of stroke
1. Ischemic stroke
Most common type
A clot blocks and impairs blood flow, cause lack of
oxygen and nutrients to the brain
Embolism stroke –
blood clot travel to the brain
Thrombosis stroke –
blood flow is blocked to the brain
Physical Rehabilitation: Chapter 18 stroke, page 705
2. Hemorrhagic stroke
Blood vessel rupture, causing leakage of blood in or
around the brain
Physical Rehabilitation: Chapter 18 stroke, page 705
Controllable Uncontrollable
High blood pressure
Artrial fibrillation
High cholestrol
Diabetes
Atherosclerosis
Circulation problems
Tobacco used and smoking
Alcohol use
Physical inactivity
Obesity
Age Gender Race Family history Previous stroke/ TIA Fibromuscular
Dyslapsia Patent Foramen Ovale
(PFO or hole in the heart)
http://www.stroke.org/site/PageServer?pagename=RISK
http://neuro4students.wordpress.com/pathophysiology/
http://neuro4students.wordpress.com/pathophysiology/
1. Sudden numbness or weakness of the
face, arm, or leg, especially on one side of
the body.
2. Sudden confusion, trouble speaking or
understanding.
3. Sudden trouble seeing in one or both eyes.
4. Sudden trouble walking. Dizziness, loss of
balance or coordination.
5. Sudden, severe headaches with no known
cause.
Physical Rehabilitation: chapter 18 Stroke, page 707
Hemorrhagic stroke
Drugs and blood transfusion product that
clot the blood.
Surgical blood vessel repair
1. Surgical clipping
2. Coiling (endovascular embolization)
3. Surgical AVM removal
http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=treatments-and-
drugs
Ischemic stroke
Therapy with clot-busting drugs (within 4.5hours)
Example: heparin, warfarin (Coumadin), aspirin, or
clopidogrel (Plavix).
Intravenous injection of tissue plasminogen
activator (TPA) – restore blood flow by dissolving
blood clot.
Emergency procedures
1. Medication delivered directly into the brain.
2. Mechanical clot removal
Other procedures:
1. Carotid endarterectomy
2. Angioplasty and stents http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=treatments-and-
drugs
Improve balance and walking.
Increase ability to roll/move in bed/sit/stand
Reduce muscle spasms, pain and stiffness
Increase strength
Retrain normal patterns of movement
Increase affected arm and leg function
Increase energy levels
Increase independence and quality of life
Reduce the risk of falls http://www.manchesterneurophysio.co.uk/stroke/physiotherapy-treatment-cva.html
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