Computed tomography is a type of brain scanning that may or may not require an injection of a dye Computed tomography is used to detect intracranial bleeding, space-occupying lesions, cerebral edema, infarctions, hydrocephalus, cerebral atrophy and shifts of brain structures. PREPROCEDURE INTERVENTION POSTPROCEDURE INTERVENTION

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