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 RISK FACTORS ASSESSMENT

1. CEREBROVASCULAR
ACCIDENT

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

6. ASSESSMENT

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