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CEREBROVASCULAR
ACCIDENT
DESCRIPTION
 Cerebrovascular accident is a sudden focal neurological deficit caused by
cerebrovascular disease
 Cerebrovascular accident is a syndrome in which the cerebral circulation is
interrupted , causing neurological deficits
 Cerebral anoxia lasting longer than 10 minutes causes cerebral infarction
with irreversible change
 Surrounding cerebral edema and congestion cause further dysfunction
 Diagnosis is determined by computed tomography scan ,
electroencephalogram and cerebral arteriography
 The permanent disability cannot be determined until the cerebral edema
subsides
 The order in which function may return is facial swallowing , lower limb,
speech , and arms
 Carotid endarterectomy is a surgical intervention used in stroke
management and is targeted at stroke prevention especially in clients with
symptomatic carotid stenosis
CAUSES
 Thrombosis
 Embolism
 Hemorrhage from rupture of a vessel
 Transient ischemic attack
RISK FACTOR
 Atherosclerosis
 Hypertension
 Anticoagulation therapy
 Diabetes mellitus
 Stress
 Obesity
 Oral contraceptives
ASSESSMENT
NEUROLOGICAL ASSESSMENT IN
CEREBROVASCULAR ACCIDENT
 Changes in level of consciousness
 Signs of increasing intracranial pressure
 Assessment of Cranial nerves V, VII, IX, X and XII
 Cranial nerve V : Difficulty with chewing
 Cranial nerve VII : Facial paralysis or paresis
 Cranial nerve IX and X : dysphagia
 Cranial nerve IX : absent gag reflex
 Cranial nerve XII : impaired tongue movement
ASSESSMENT FINDINGS IN CVA
 AGNOSIA : inability to use an object correctly
 APRAXIA : inability to carry out a purposeful activity
 HEMIANOPSIA : blindness in half of the visual field
 HOMONYMOUS HEMIANOPSIA : blindness in the same visual field of
both eyes
 NEGLECT SYNDROME (UNILATERAL NEGLECT) : Client unaware of the
existence of his or her paralyzed side
 PROPRIOCEPTION ALTERATIONS : altered position sense that places the
client at increases risk injury
 PYRAMID POINT : with visual problems, client must turn the head to scan
the complete range of vision
ASSESSMENT
 Assessment findings depend on the area of the brain affected
 Lesions in the cerebral hemisphere result in manifestations on the
contralateral side, which is the side of the body opposite the
cerebrovascular accident.
 Airway patency is always a priority
 Pulse (may be slow and bounding)
 Respirations (Cheyne- stroke)
 Blood pressure( hypertension)
 Headache, nausea, and vomiting
 Facial drooping
 Nuchal rigidity
 Visual changes
 Ataxia
 Dysarthria
 Dysphagia
 Speech changes
 Decreased sensation to
pressure , heat, and cold
 Bowel and bladder dysfunctions
 Paralyses

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CEREBROVASCULAR ACCIDENT.pptx

  • 2. DESCRIPTION  Cerebrovascular accident is a sudden focal neurological deficit caused by cerebrovascular disease  Cerebrovascular accident is a syndrome in which the cerebral circulation is interrupted , causing neurological deficits  Cerebral anoxia lasting longer than 10 minutes causes cerebral infarction with irreversible change  Surrounding cerebral edema and congestion cause further dysfunction  Diagnosis is determined by computed tomography scan , electroencephalogram and cerebral arteriography
  • 3.  The permanent disability cannot be determined until the cerebral edema subsides  The order in which function may return is facial swallowing , lower limb, speech , and arms  Carotid endarterectomy is a surgical intervention used in stroke management and is targeted at stroke prevention especially in clients with symptomatic carotid stenosis
  • 4. CAUSES  Thrombosis  Embolism  Hemorrhage from rupture of a vessel  Transient ischemic attack
  • 5. RISK FACTOR  Atherosclerosis  Hypertension  Anticoagulation therapy  Diabetes mellitus  Stress  Obesity  Oral contraceptives
  • 7. NEUROLOGICAL ASSESSMENT IN CEREBROVASCULAR ACCIDENT  Changes in level of consciousness  Signs of increasing intracranial pressure  Assessment of Cranial nerves V, VII, IX, X and XII  Cranial nerve V : Difficulty with chewing  Cranial nerve VII : Facial paralysis or paresis  Cranial nerve IX and X : dysphagia  Cranial nerve IX : absent gag reflex  Cranial nerve XII : impaired tongue movement
  • 8. ASSESSMENT FINDINGS IN CVA  AGNOSIA : inability to use an object correctly  APRAXIA : inability to carry out a purposeful activity  HEMIANOPSIA : blindness in half of the visual field  HOMONYMOUS HEMIANOPSIA : blindness in the same visual field of both eyes  NEGLECT SYNDROME (UNILATERAL NEGLECT) : Client unaware of the existence of his or her paralyzed side  PROPRIOCEPTION ALTERATIONS : altered position sense that places the client at increases risk injury  PYRAMID POINT : with visual problems, client must turn the head to scan the complete range of vision
  • 9. ASSESSMENT  Assessment findings depend on the area of the brain affected  Lesions in the cerebral hemisphere result in manifestations on the contralateral side, which is the side of the body opposite the cerebrovascular accident.  Airway patency is always a priority  Pulse (may be slow and bounding)  Respirations (Cheyne- stroke)  Blood pressure( hypertension)  Headache, nausea, and vomiting  Facial drooping
  • 10.  Nuchal rigidity  Visual changes  Ataxia  Dysarthria  Dysphagia  Speech changes  Decreased sensation to pressure , heat, and cold  Bowel and bladder dysfunctions  Paralyses