Cerebral Vascular Accident Review

Question 1

What are the most common sites for a stroke to occur?

Answer 1

Common carotid artery, main bifurcation of the MCA, and the junction of the vertebral arteries with the basilar artery

Question 2

What are some common things sings with a MCA lesion?

Answer 2

• Contralateral hemiplegia, mostly upper extremities
• Homonymous hemianopsia
• May produce aphasia and apraxia if in dominant side of brain
• Can also cause global aphasia if occlusion occurs in main stem of MCA

Question 3

What are some common things seen with an anterior cerebral artery stroke?

Answer 3

Rarely involved
Lower extremity more frequently affected (contralateral hemiplegia)
Can result in mental confusion, aphasia, and contralateral neglect

Question 4

What common occurs with a posterior cerebral stroke?

Answer 4

Persistent pain syndrome or contralateral pain and temperature sensory loss
Homonymous hemianopsia, aphasia, and thalamic pain syndrome

Question 5

Which artery is often affected if a patient has a high chance of death, has a result of quadriplegia and “locked-in syndrome”

Answer 5

Vertebral-basilar

Question 6

If the anterior inferior cerebellar artery is affected what are common symptoms.

Answer 6

Unilateral deafness, loss of pain and temp on contralateral side, paresis of lateral gaze, unilateral corners syndrome, ataxia, vertigo, and nystagmus

Question 7

Describe the 6 stages of recovery following a stroke

Answer 7

1. Flaccidity is present with no voluntary movement
2. Synergies may appear. Spasticity begins to develop
3. Spasticity increases and may become severe. Voluntary control of synergies appears
4. Some movement independent of the synergies. Spasticity begins to decline
5. Spasticity is gone. Coordination and movement approaches normal.

Question 8

What are the 2 types of synergies.

Answer 8

Flexion and extensor synergies

Question 9

Describe an upper extremity flexion synergy

Answer 9

Scapular elevation/retraction
Shoulder abduction and ER
Elbow flexion (generally the strongest)
Forearm supination and wrist/finger flexion

Question 10

Describe a lower extremity flexion synergy

Answer 10

Hip flexion (generally strongest), abduction, ER
Knee flexion
Ankle DF and inversion
Toe DF

Question 11

Describe the perceptual problems associated with a right hemisphere stroke

Answer 11

Problems with spatial relationships and hand eye coordination
Irritability, short attention span
Can’t retain information, difficulty learning individual steps
Poor judgement affecting personal safety
Diminished body image with left-sided neglect
Quick and impulsive

Question 12

Describe the perceptual problems associated with a left hemisphere stroke

Answer 12

Apraxia
Difficulty starting a sequencing task
Perseveration
Easily frustrated with high levels of anxiety
Inability to communicate verbally
Cautious and slow

Question 13

Describe fluent aphasia

Answer 13

(receptive aphasia, Wernicke’s). Speech is preserved but auditory comprehension is impaired.

Question 14

Describe Non-fluent aphasia

Answer 14

(expressive, Broca’s) Speech is awkward or restricted. Phrase questions for simple yes/no responses