Stroke- Clinical Features And Management

Question 1

Hemiplegia/hemiparesis definition

Answer 1

Paralysis of one side of body
Due to crossing of pathways in medulla of brainstem
Rt CVA- Lt hemiplegia
Lt CVA- rt hemiplegia

Question 2

Motor symptoms of stroke

Answer 2

Tone alterations (low,high, ataxia)
Weakness
Asymmetry
Loss of normal movement pattern
Loss of postural adjustments- loss of balance
Compensations

Question 3

Sensory symptoms

Answer 3

Sensory impaired- impaired cutaneous sensation, sterognosis, proprioceptive impairment
Visual impairment- visual field loss, homonymous hemonopia

Question 4

Speech symptoms

Answer 4

Dysarthria
Expressive dysphasia (Brocas)
Receptive dysphasia (wernickes)
Global aphasia

Question 5

Cognitive symptoms

Answer 5

Perceptual problems- agnosia, astereognosis, visual agnosia, auditory agnosia, depth perception
Apraxia
Anosagnosia
Inattention/neglect

Question 6

Neglect

Answer 6

Fail to attend to stimuli from left side
Poor prognosis if persists
Functional problems- self care, eating, dressing, walking

Question 7

Other related problems to hemiparesis

Answer 7

Emotional disorders
Dysphasia 
Incontinence 
Secondary msk problems
Balance/gait problems
Functional difficulties 
Social problems

Question 8

Physio treatment for hemiparesis

Answer 8

Prevent complications,minimise impairments, max function
Assessment
Identification of problems
Clinical reasoning 
Goal setting
Obj outcomes
Choice of Rx methods
Interdisciplinary input

Question 9

Factors affecting hemiparesis recovery

Answer 9

Extent and nature of lesion
Integrity of collateral circulation
Pre-morbid status
Age
Capacity of nervous system to re-organise
Environment
Motivation and patients attitude
Patient participation
Patient experience
Co- existing conditions
Nutrition/hydration
Medication