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What is the most common site for CVA's?

Middle Cerebral artery
What is a CVA?
*Permanent reduction of blood flow
*Infarct of brain tissue caused by oxygen deprevation
What is the most common diagnosis seen by OTs
What is hemiplegia?
paralysis of one side. The side opposite the CVA
What is hemiparesis?
weakness; partial motor loss on one side. The opposite side of the CVA
What is a TIA?
Trans Ischemic Attack
It is a temporary reduction of blood flow, a mini-stroke
blockage (reduction in flow)
Death (tissue dies)
Name 3 etiologies of CVA
1 Thrombus
2 Embolus
3 Hemorrhage
Which etiology is the most common?
Thrombus 53-58% of CVA
Which etiology is the most deadly?
Hemorrahge type CVA's
Describe Thrombus
-Due to blockage from blood clot
-atheroscherosis: fatty deposits in arteries
-Due to lifestyle choices
-Occurs at night, & pt's unaware
Describe Embolus
-Traveling blood clot
-clot can be a piece from thrombus or other material
Describe Hemorrhagic
-Ruptured aneurysm or caused by a trauma (MVA)
Characteristic of Strokes are?
-come on suddenly
-symptoms are focal (specific area of brain)
-can be mild or severe
What are the Risk Factors for a CVA? 2 most common
1- age
2- cardiac disease
What are the controllable factors:
-birth control w/headaches and smoking
-diabetes (along w/other unhealthy habits)
What are the UNcontrollable factors:
Usually genetics.
Chinese, Japanese and African Am
What is the most modifiable risk factor
High blood pressure
What are the 2 effects of a stroke?
-Motor and sensory
(problems with movement)
What are the warning signs?
How long do TIAs last? And what are they a prelude to?
*they can last 2-15 minutes, rarely over 30 minutes.
* A major stroke! may follow after 1 or more TIA's
How long before a major stroke after TIA's
major stroke can follow hours, weeks or months after TIA
Dysfunctions following a CVA
- flaccidity/hypotonicity
- sensation loss/chg
- cognition deficits
- behavior/personality chgs
- speech/language deficits
- vision impairments/chgs
What do the outcomes and severity of CVA depend on?
It depends on the
and density of the brain damage
Poor Prognosis is indicated by what factors?
1. the amt of edema causing intracranial pressure
2. edema in comatosed pts.
3. How long the pt is flaccid
What can cause a favorable prognosis?
Early spasticity
How long before the brain stops swelling due to CVA?
Usually reaches at peak in 3-4 days then subsides
What is the recovery period for small infarcts vs severe infarcts?
small infacts(mini-strokes): 1-2 days
In severe CVA's: spontaneous recovery of motor func can occur in 3 months. But typically it takes pt's 5-6 months then they plateau. Studies do show that improvments continue years post CVA
What type of medical complications are stroke pt's prone too?
-Subluxation of the GH joint
1. due to spasticity 2. due to flaccidity
-Decubitus Ulcers
What are the problem areas?
-abnormal reflexes
-abnormal MS tone
-motor skills deficits (recovery begins proximal to distal)
-balance impairments
-motor problems (fine & gross)
OT treatment techniques: 11 of them
-PROM/AROM: maintain ROM to prevent deformity; serial casting
-Treat pain and subluxation: rest arm on lap trays, arm trough, use a sling only when walking
-Motor retraining: work on posture and movement (include the affected arm- it can hold things down, up, stablizer)
-normalize MS tone: facilitate for flaccilidity & inhibit for spasticity
-bilateral integration
-strength and endurance
-edema control: elevation, retrograde massage,PAMS (cold)
-compensatory techniques: one-handed techniques
-sensory retraining- rubbing area, exposing to diff textures
-visual: hemianopsia-use anchoring technique, diplopia-patch one eye
-tactile: (any of the sensory losses) compensate w/vision
-olfactory and gustatory: safe guard the environment
Staggering gate, postural imbalance is:
Difficulty Swallowing is called:
A State of motor hypoactivity or muscular paralysis is known as:
The impaired ability to write is known as
Hint: graphite pencil writes
The Loss of ability to recognize familiar persons or objects is:
The condition in which: language cannot be understood

words cannot be formed or expressed

or both is known as:

Poorly articulated speech secondary to interference in control of the muscles of speech is called:
Double Vision is known as:
Inability to perform purposeful acts, such as using a fork or a telephone is called:
Inability to perceive a defect, particularly paralysis, on one side of the body is called:
Visual defect in the right or left halves of the visual fields of both eyes is refered to as:
Homonyous Hemianopia
Paralysis of one side of the body is called:
The patient has muscular weakness on one side of the body, this is refered to as:
Inability to write

*Dont confuse with Dysgraphia:impaired ability to write

The inability to produce language:
Expressive Aphasia
Inability to comprehend spoken or written word
Receptive Aphasia

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