CVA impairments pt. 2: vision & vestibular Flashcards
CN II and associated CNS areas damaged from CVA, what visual dysfunction will the pt have
CN II and associated CNS areas
- refractive errors
- myopia
- hyperopia
- astigmatism
- blurry vision, headaches, dizziness
CN II and various regions of visual tract damaged from CVA, what visual dysfunction will the pt have
- impaired accomodation: blurry vision, HA, dizzy
- visual field loss
cerebellum damaged from CVA, what visual dysfunction will the pt have
- impaired pursuits and saccades: dizzy, nausea, balance issues
- diplopia: nausea, balance issues
CN II, III, IV, VI nuclei and associated CNS areas damaged from CVA, what visual dysfunction will the pt have
- ptosis
- ocular motility disturbances
- diplopia, visual distortions, dysconjugate gaze, impaired vergence: dizzy, nausea, balance issues
optic n. lesion
ipsilateral blindness
optic chiasm - bilateral lateral compression lesion
binasal hemianopia
optic chiasm - midsagittal transection/pressure lesion
bitemporal hemianopia
optic tract L lesion
right heminopia
optic radiation L - lower division lesion
right upper quandrantanopia
optic radiation L - upper division lesion
right lower quandrantanopia
optic radiation L - both divisions lesion
right hemianopia with macular sparing
tropia -
overt deviation of the eye
phoria
ocular deviation occurs when dissociation occurs - when fatigued or doing a cognitive task
esotropia is damage to what CN
loss of abduction
6 - abducens
exotropia is damage to what CN
loss of adduction
CN 3
hypertrophia is damage to what CN
loss of depression
CN3 and 4
hypotrophia is damage to what CN
loss of elevation
CN 3
if ocular misalignment issues is severe ..
diplopia
head tilt
noticeable eye turn
if ocular misalignment is subtle ..
- diffuclty maintaining focus
- cosmetically normal
- oculare soreness
- HA
- mental dullness
damage to cortical vestibular regions (PIVC, MST, VTR) impacts what
integration and regulation of vestibular systems
damage to flocculonodular lobe results in what
VOR dysfunction
postural instabilities
damage to brainstem vestibular regions (midbrain, pons) results in what
VOR, VSR, VCR dysfunction
what is the most common complaint with vestibular dysfunction
dizziness
25% of ED visits due to dizziness are found to have a TIA/CVA
transient ischemic attacks most common site:
what will you see with these
- vertebrobasilar artery
- vertigo
- visual deficits
what are the two brainstem & cerebellar strokes that will have vestibular dysfunction
- PICA stroke (wallenbergs syndrome)
- AICA stroke
what is the main presenting sign that helps you differentiate btw a PICA and AICA stroke
AICA will have hearing deficits
what cortical stroke will have vestibular dysfunction
- MCA/PCA territory infarcts
- more mild symptoms
where are the nuclei (and what are they) that are reliable for VOR dysfunction from a brainstem stroke
- midbrain: oculomotor nucleus
- pons: abducens nucleus
