ALTERATIONS OF THE ALTERATIONS OF THE NERVOUS SYSTEMNERVOUS SYSTEMCLINICAL MANIFESTATIONS OF A CVA

Clinical ManifestationsClinical ManifestationsVary dependent on the cerebral

artery involvedS & S always sudden on onsetFocal and usually one sidedCommonly weakness involving

face & armChanges with the sensesOpposite side of brain affected

Homonymous Homonymous HemianopsiaHemianopsia

Cerebrovascular AccidentCerebrovascular AccidentClinical ManifestationsClinical ManifestationsRight Brain – Left Brain Right Brain – Left Brain DamageDamage

Clinical ManifestationsClinical Manifestations

Motor Function ImpairmentCaused by destruction of motor

neurons in the pyramidal pathway (brain to spinal cord)MobilityRespiratory functionSwallowing and speechGag reflexSelf-care activities

Clinical ManifestationsClinical Manifestations

AffectDifficulty controlling emotionsExaggerated or unpredictable

emotional responseDepression / feelings regarding

changed body image and loss of function

Clinical ManifestationsClinical Manifestations

Intellectual FunctionMemory and judgment

Left-brain stroke: cautious in making judgments

Right-brain stroke: impulsive & moves quickly to decisions

Difficulties in learning new skills

Cerebrovascular AccidentCerebrovascular AccidentClinical ManifestationsClinical Manifestations

Communication

Receptive Aphasia (Wernicke’s area): impaired comprehension of language – spoken & written

Expressive Aphasia (Broca’s area): difficulty in speaking and writing

Dysarthria: poor control of muscles for speech

Clinical ManifestationsClinical Manifestations

Spatial-Perceptual Alterations 1. Incorrect perception of self & illness2. Neglect syndrome: unaware of the

existence of the affected side 3. Agnosia: Inability to recognize an

object by sight, touch or hearing4. Apraxia: Inability to carry out learned

sequential movements on command

Clinical ManifestationsClinical Manifestations

Elimination

Most problems occur initially and are temporary

One hemisphere stroke: prognosis is excellent for normal bladder function

Bowel elimination: constipation associated with immobility, weak abdominal muscles, dehydration