Based on research and several readings.

1. CHALLENGES OF A STROKE PATIENT
BY PHILANS COSMOS ANKRAH

3. Symptoms of a stroke depend on the area of the brain affected

4. ..BRIEF NEUROANATOMY

5. ..BRIEF NEUROANATOMY

7. What is stroke???

8. WHO defined stroke as a "neurological deficit of cerebrovascular cause
that persists beyond 24 hours or is interrupted by death within 24 hours“

9. How to diagnose a stroke with physical assessment
The general disabilities of stroke
Dissecting the disabilities of stroke
CONTENT…

10. The results of stroke vary widely
depending on size and location of the
lesion.
Dysfunctions correspond to areas in the
brain that have been damaged.
Physical Diagnoses of CVA

11. Act F.A.S.T.
• F – Face
• A – Arm and leg
• S – Speech
• T – Time to act fast.
Physical Diagnoses of CVA

12. Generally, stroke can cause five types of disabilities
A. Paralysis or problems controlling movement
B. Sensory disturbances including pain
C. Problems using or understanding language
D. Problems with thinking and memory
E. Emotional disturbances
GENERAL DISABILITIES

13. Parts of brain responsible more motor
functions
Mostly one sided: side of body opposite side of
brain damaged.
Synergistic patterns
Basically either:
 Plegia
 Paresis
 Ataxia
A. MOTOR PROBLEMS

14. i. Facial paralysis

15. initial flaccidity (hypotonicity), replaced by spasticity (hypertonicity),
hyperreflexia, and obligatory synergies
Loss of control in; supraspinatus, posterior deltoid, triceps brachii,
serratus anterior, extensors of the wrist and fingers, supinator
Spasticity in; biceps, internal rotators of the shoulder, adductors, wrist
and finger flexors
Presentation of limb…???
Shoulder subluxation ***
ii. Scapula + upper limb

16. initial flaccidity (hypotonicity), replaced by spasticity (hypertonicity),
hyperreflexia, and obligatory synergies
Abnormal synergies
Loss of control in; hamstrings, dorsiflexors, hip internal rotators,
abductors
Spasticity in; quads, plantarflexors,
Presentation of limb…???
Hip subluxation ***
iii. Pelvis + lower limbs

17. Loss of ability to feel touch, pain, temperature, or position
Hemianopia
Problems with stereognosis
Loss of urinary continence and at-times bowel continence often results
from a combination of sensory and motor deficits.
Thalamic pain syndrome ***
Frozen joint
C. SENSORY DISTURBANCES INCLUDING PAIN

18. APHASIA- problems using or understanding language
 Broca’s area and expressive aphasia
 Wernick’s area and receptive aphasia
 Global aphasia
Dementia
Memory
D. COGNITIVE DEFICITS

19. Stroke survivors may experience deficits in short-term memory.
Loss of ability to make plans, comprehend meaning, learn new tasks, or
engage in other complex mental activities.
Anosognosia
Neglect
Denial
Apraxia
E. PROBLEMS WITH THINKING AND MEMORY

20.  Mood swings
 Emotions
 Fear
 Anxiety
 Frustration
 Anger
 Sadness
 Depression
 Grief over loss.
EMOTIONAL DISTURBANCES

21. Visual problems
Insomnia/ hypersomnia
Sexual dysfunction
Seizures
Fatigue
Other problems...

22. Gift of nature to mankind
Adaptability
Neuroplasticity doesn’t necessarily change
exercise and therapeutic activities done in
stroke rehabilitation but rather emphasizes
that more repetition and task specific practice
is needed.
NEUROPLASTICITY

23.  Pascual-Leone A., Amedi A., Fregni F., Merabet L. B. (2005). "The plastic
human brain cortex". Annual Review of Neuroscience 28: 377–401.
 Donnan GA, Fisher M, Macleod M, Davis SM (May 2008). "Stroke". Lancet
371 (9624): 1612–23
 O'Sullivan, Susan.B (2007). "Stroke". In O'Sullivan, S.B., and Schmitz, T.J.
Physical Rehabilitation 5. Philadelphia: F.A. Davis Company. p. 719.
REFERENCES

24. Thank you…