Ax And Mx Of Impairments Following Stroke

Question 1

TACS

Answer 1

Total anterior circulation stroke

All three
Hemiplegia +- sensory loss
Hemianopia
Cortical signs (non-motor)
Most severe stroke

Question 2

PACS

Answer 2

Partial anterior circulation stroke

Two of the following
Hemiplegia +- sensory loss
Hemianopia
Cortical signs

OR isolated cortical dysfunction OR pure motor or sensory signs less severe than lacunar

Question 3

LACS

Answer 3

Lacunar stroke

Hemiplegia +- sensory loss affecting at least 2/3 of face/arm/leg
No cortical signs

Question 4

POCS

Answer 4

Posterior circulation stroke

Cranial nerve palsies
Ipsilateral motor/sensory deficits
Eye mvmt disorders
Isolated hemianopia
Cerebellar deficits

Question 5

Differentiate between lesions of dominant and non-dominant cerebral hemispheres (impairment presentations)

Answer 5

Left hemisphere usually dominant

Left - language and analytical functions, slow mvmt, depressed or anxious

Right - visuospatial skills, attention (neglect), impulsive mvmt, unrealistic attitude, labile, unmotivated

Question 6

List categories of Bamford stroke classification and impairments associated with each category

Answer 6

Stroke - acute onset of neurological deficit lasting greater than 24hrs or leading to death. Vascular cause.

TACS - total anterior
PACS - partial anterior
LACS - lacunar
POCS - posterior

C = circulation
S = syndrome (indeterminate)
I = infarct
H = Haemorrhage

Question 7

List primary impairments of stroke

Answer 7

Sensorimotor - neg (decreased mm strength, coordination and sensation) and positive (spasticity)

Non-motor - decreased vision, speech or language, perceptual function, cognitive function, apraxia, behavior, emotion

Question 8

List secondary impairments of stroke

Answer 8

Motor - decreased mm length (contracture), fitness, strength, cardiovascular deconditioning
Non-motor- Learned non-use, compensatory mvmts, swelling, should subluxation, soft tissue damage

Question 9

Define dysphagia

Answer 9

Difficulty with swallowing

Question 10

Define dysarthria

Answer 10

Difficulty with articulation

ie muscular problem

Question 11

Define a hemianopia

Answer 11

Loss of visual field on side of Hemiplegia (same side as stroke)

Question 12

Define conjugate gaze

Answer 12

Eye movements

Question 13

Define aphasia/dysphasia

Answer 13

Difficulty with the spoken word. Non motor.

Receptive - can’t understand what is being said to them
Expressive - find some words but not others
Global - both

Question 14

Define agnosia

Answer 14

Inability to recognize objects

Question 15

Define apraxia/dyspraxia

Answer 15

Inability to plan or execute movements

Idiomotor - inability to execute on external commands
Ideational - inability to perform complex activities eg making coffee