ALTERATIONS OF THE ALTERATIONS OF THE CENTRAL NERVOUS CENTRAL NERVOUS SYSTEMSYSTEMAssessment of a CVA

F.A.S.TFaceArmsSpeechTime*

*http://www.stroke.org/site/News2?page=NewsArticle&id=9015&news_iv_ctrl=1222

Cerebrovacular AccidentCerebrovacular Accident Neurological Neurological

AssessmentAssessmentCognitiveMotor SensoryCranial Nerve FunctionCardiovascular assessmentPsychosocial assessment

Cognitive AssessmentCognitive AssessmentIntellectual Function

-memory -judgment

-problem solving/ decision making -speech

Motor AssessmentMotor AssessmentMotor changes

-hemiplegia (paralysis) -hemiparesis (weakness) -muscle tone (hyper or hypotonia) -motor activity (agnosia/ apraxia) -bowel/bladder control -gag reflex/ swallowing -self care

Sensory AssessmentSensory AssessmentSensory changes

-sensory loss (touch, pain, heat, cold)

-neglect syndrome -spatial/proprioceptive

-hemianopsia -Amaurosis fugax

Cranial Nerve AssessmentCranial Nerve Assessment

Functional Abnormalities-Assess any difficulties in

chewing, swallowing-Assess any facial paralysis

Cardiovascular Cardiovascular AssessmentAssessmentObtain patient history: heart

murmur, TIAAssess vital signs especially BP

- history of hypertension

Psychosocial AssessmentPsychosocial AssessmentAssess patient’s reaction to

illnessAssess behavioral changes:

-emotional lability -mood changes ( fear, anger, depression) -assess effect on financial status, job

Hemorrhagic-SubarachnoidHemorrhagic-SubarachnoidCerebral AneurysmCerebral Aneurysm

Warning Symptoms: sudden onset of a severe headache – “worst headache of one’s life”

Change of LOC, Neurological deficits, nausea, vomiting, seizures, stiff neck

Prognosis: many patients die or left with significant cognitive difficulties

Diagnostic TestsDiagnostic TestsCAT scanMRI/ MRASPECT (Single-photon emission

computed tomography)

Carotid Doppler StudiesAngiographyLumbar punctureGlascow Coma Scale: monitor

neurological status