Patients with lesions in this hemisphere are slow, cautious, hesitant, and insecure with contralateral hemiplegia. Aphasia
Left hemisphere lesion
Patients with this side lesion are impulsive, quick, indifferent, have poor judgement and safety awareness. Overestimate abilities and underestate their problems. Perceptual deficits
Right hemisphere lesion
What are the stages of CVA recovery?
Flaccidity
Spasticity, synergies
Voluntary movements in synergy
Voluntary control w/ decreased spasticity and synergies
Increasing voluntary control out of synergy
Control and coord near normal
Most affected artery with CVA's?
MCA: middle cerebral artery
ACA: anterior cerebral artery
Left hemi treatment for learning
Develope appropriate communication base
Frequent feedback and support
Right hemi treatment for learning
Verbal cues
Frequent feedback to slow down
Focus on SAFETY
Avoid clutter
Which artery is affected?:
Contralat hemiplegia mostly of UE's
Homonymous hemianopsia
Infart in left hemi= aphasia & apraxia
MCA: middle cerebral artery
Which arterywas affected?:
Contralat hemiplegia mostly of LE's
Contralat neglect
Aphasia & mental confusion
ACA: anterior cerebral artery
Which artery was affected?:
Peristent pain
Homonymous hemianopsia
Aphasia
PCA: posterior cerebral artery
Which artery was affected?:
Often result is death
Locked in state
Vertebral-basilar artery
Contralat loss of pain and temp
Ataxia Vertigo
Dysphasia
Ptosis
Anterior/ inferior cerebellar ateries
Superior cerebellar artery
Word repetition and Manuel cues should be used with which type of aphasia?
Receptive / wernicke's
Simple yes and no questions should be used with which type of aphasia?
Expressive / broca's
Symbolic gestures should be used with which type of aphasia?
Global
CVA gait deviations:
1. weak hip ext/flex contracture a) knee hyperextension
2. weak abd on contralateral side b) equinus gait
3. flex contracture/weak extensors c) FWD trunk
4. PF contracture/spastic quads/weak extensors d) trendelenburg
5. gastroc soleus contracture e) excess knee flex
1. c)
2. d)
3. e)
4. a)
5. b)
What synergy?
elbow flex
shld abd
scap elev and retraction
forearm supination
wrist and finger flex
flexion synergy
What synergy?
elbow ext
shld add
scap depression and protraction
forearm pronation
wrist and finger flexion