Basics of Cerebrovascular Accident (CVA)

Nurse Assessing Stroke Victim By Raising ArmsCerebrovascular Accident (CVA) also known as “Stroke” happens when there is an interruption in the brain’s blood circulation (ischemia) or there is destruction or death of surrounding brain tissue (infarct) . CVA happens when there is prolonged ischemia to an artery within the brain. This, depending on the size of the affected area in the brain can cause neurological damage specific to the affected area’s function. However, there are modifiable risk factors of CVA which include hypertension or high blood pressure, heart disease, diabetes, elevated cholesterol, smoking, obesity and atherosclerosis. Atherosclerosis is the build up of fats, cholesterol and other substances in and on the artery walls. The non-modifiable factors are age, race, family history and sex. Fortunately, Stroke is treatable and can be prevented but one should be able to recognize the symptoms.

Face– Ask the person to smile and observe if one side is drooping

Arms– Ask the person to lift both arms and observe if one arm drifts downward or the person is unable to bring one up.

Speech-Ask the person to repeat a simple sentence or phrase and observe if the speech is slurred

Time– if any of these signs are present it is imperative to call 911 right away.

As mentioned above, depending on the location, and severity of the infarct, a person who suffered CVA may present with paralysis on one side of the body ( hemiplegia), or slight paralysis or weakness on one side of the body (hemiparesis), impaired processing, heightened frustration, difficulty speaking (aphasia), difficulty swallowing ( dysphagia), difficulty initiating a movement or planning to perform a task (motor apraxia), blindness over half the field of vision ( hemianopsia), poor attention span, impaired awareness and judgement, spatial deficits, ,memory deficits and impulsive behavior.

A physical therapist during the acute phase can aid with positioning, pressure relief, sensory awareness and integration, range of motion, weight bearing, facilitation, muscle re -education, balance and postural control. Depending on the remaining neurological deficits due to CVA, a physical therapist may assist with the patient’s A.) motor re-education such as bringing the arm up or opening the hand which may be closed into a fist or moving the ankle up, B.) sensory stimulation such as being able to tell if an object is hot or cold and C.) functional mobility such as walking or standing and sitting from a chair.

A persons’ recovery depends on many factors such as the site and severity of the CVA, pre -morbid status or co- morbidities, age, family or social support, as well as motivation. According to research, a patient can continue to progress and improve for an average of 2 to 3 years after CVA.

BY: Rhia Vista, PTA

Posted in: Physical Therapy

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