Stroke classifications and rehabilitation Flashcards
What classification is used for stroke?
Oxford classification
Symptoms for Total Anterior Circulation Syndrome (TACS / TACI)?
Hemiparesis (contralateral) + Higher cortical dysfuction + Homonymous hemianopia
Symptoms of Partial Anterior Circulation Syndrome (PACS/ PACI)
Isolated higher cortical dysfunction
OR
Any two of:
* hemiparesis
* higher cortical dysfunction
* homonymous hemianopia
Symptoms of Posterior Circulation Syndrome (POCS / POCI) ?
Isolated hemianopia
Brainstem or cerebellar syndrome, shown as one of:
* cranial nerve palsy and contralateral motor/sensory deficit
* bilateral motor/sensory deficit
* conjugate eye movement disorder
* cerebrallar signs - vertigo, nystagmus, ataxia
Symptoms of Lacunar Syndrome (LACS/ LACI) ?
- Pure motor stroke
OR - Pure sensory stroke
OR - Sensorimotor stroke
OR - Ataxic hemipareis
Vascular territory for TACI/TACS?
Proimal MCA or ACA occluded
Vascular territory for PACS/PACI?
Branches of MCA - upper div or lower div
Vascular territory for POCI/POCS?
Occlusion of vertebrobasilar arteries - so includes vertebral, basilar, cerebellar or PCA vessels
Vascular territory of LACS/LACI?
Lentiulostriate branches of MCA
OR
Blood supply to brainstem or deep white matter (Internal capsule or thalamus)
Define rehabilitation
Goal oriented exercise
Define reablement
Reablement is a type of care that helps you relearn how to do daily activities, like cooking meals and washing
What services are involved in rehabilitation?
Mobility services
Speech and language therapy
Cognitive therapy
Managing spasticity
Envirobemntal modifications to enable goals to be reached
Who is involved in rehab?
Doctors
Rehab nurses
OTs
Physio
Speech and language therapists
Social workers
Psychologists
Carers
What are barriers to stroke rehabilitation/recovery for patients?
- Physical deficits
- Cognitive deficits
- Mood
- Medication issues
- Lack of support
- Lack of resources - including the skill of the rehab team
- Stigma
- Culture
When does rehab begin?
24-48hrs post stroke, usually in acute stroke unit