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Right CVA


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General Symptoms
Insensitive to others and preoccupied with self, oblivious to social conventions, unaware of or inattentive to physical and mental limitations, verbose, tangential, Insensitive to the meaning of abstract or implied material, Unable to grasp the overall significance or meaning of complex events, utterances are short and lack inflection, difficulty maintaining attention
Right hemisphere most resemble
communicative and cognitive impairment of frontal lobe damage
Perceptual Impairments
denial of illness, neglect, constructional Impairment, topographic impairment, geographic disorientation, visuoperceptiual impairment, facial recognition deficits, recognition and expression of emotion, attention impairment
Denial of illness
fail to perceive tactile stimulation on the left side of the body and fail to notice visual or auditory stimuli in left-sided space
Constructional Impairment
perform poorly when asked to draw or copy geometric designs, create designs with colored blocks, reproduce two-dimensional stick figures, or reproduce three-dimensional constructs using wooden blocks - who cares
Topographic Impairment
difficulty relating to extrapersonal space. Difficulty following routes, reading maps, giving directions and performing other tasks that depend on internal representations of external space
Geographic Disorientation
recognize at least the general nature of their surroundings but are mistaken about their geographic location
Visuoperceptual Impairments
difficulty identifying line drawings of objects when one drawing is superimposed on another. When visual stimuli are simple, clear and unambiguous they respond normally
Facial recognition deficits
Unable to recognize otherwise familiar persons by their facial features
Recognition and expression of emotions
impairments in appreciating emotions generally are attributed to deficits in 3 domains. Appreciating prosodic cues, appreciating the emotional implications of facial expressions, and appreciating the emotional tone associated with stereotypic emotional situations
Attention Impairments
Difficulty focusing, maintaining and shifting attention. Make them distractible. Difficulty to determine the overall meaning of situations and events, separate what is important from hat is not, identify relationships among element of information, maintaining appropriate patterns of interaction with conversational partners, and maintain coherence in their speech and writing
Communicative impairments associated with right-hemisphere damage
diminished speech prosody, anomalous content and organization of connected speech, impaired comprehension of narratives and conversations, pragmatic impairments
Diminished speech prosody
lacks normal variability in vocal pitch and loudness: slower than normal, reduced emphatic stress, diminished pitch variability
Anomalous Content and organization of connected speech
excessive, confabulatory and sometimes inappropriate connected speech
Impaired comprehension of narratives and conversations
Pragmatic Impairments
turn-taking, topic maintenance, social conventions and eye contact
Testing for assessing adults with right-hemisphere brain injury
Right hemisphere language battery (7 subtests), Mini inventory of right brain injury, Rehabilitation Institute of Chicago Evaluation of Communicative problems in Right-Hemisphere Dysfunction Revised
Nonstandardized Procedures
visual scanning and visual inattention, activities of daily living, sensorimotor integration, visual integration, higher cognitive and perceptual functions, linguistic and cognitive flexibility, affective state
Tests of pragmatic abilities
Supportive routines (greetings), assertive routines (complaining), formality, turn-taking, meshing (pace, timing and pauses
scale provides for rating 12 pragmatic behaviors
Pragmatic Protocol
assessment of pragmatic behaviors in conversational interactions
Tests of visual and spatial perception, attention and organization
cancellation tests (asked to make, circle or cross out lines printed at various locations, copying or drawing
Tests of component attention processes
trailmaking tasks and mazes
Left-hemisphere damage tends to produce focal impairments, whereas right hemisphere damageā¬¦
tends to produce diffuse impairment that are less amendable to quantification
Treating attention impairments and distractibility
paper and pencil or computer based tasks that target sustained attention, selective attention, alternating attention or divided attention
Treating impulsivity
external stop and go signals that are progressively shaped into patient generated self-cues
Treating Impaired reasoning and problem-solving
structured activities such as role-playing and prescriptive problem solving strategies
Treating neglect in reading
external cues to the left side of printed materials, heighten awareness to left
Treating pragmatic impairments
calling on verbal skills

Deck Info