Definition:

“CVA or stroke or brain attack is

sudden loss of neurological function

caused by an interruption of the

blood flow to the brain.” (O’Sullivan,

S. B., 2007)

Anatomy of the brain

Function:

The cortex: thinking and voluntary

movements.

The brain stem: breathing and sleep

are controlled here.

The basal ganglia: coordinate

messages between multiple other

brain areas.

The cerebellum: coordination and

balance.

http://www.webmd.com/brain/picture-of-the-brain

Lobes of the brain

The Frontal Lobe: reasoning, planning, part of speech, problem solving, judgment & motor function.

The Parietal lobe: perception of stimuli, movement, orientation, recognition

The Temporal Lobe: perception and recognition of auditory stimulation, memory and speech

The Occipital Lobe:

visual processing

http://www.webmd.com/brain/picture-of-the-brain

Left hemisphere Right Hemisphere

1. Sequential analysis:

systematic, logical

interpretation of information.

2. Interpretation and production

of symbolic information:

maths, language, abstraction

and reasoning.

3. Memory stored in language

format.

1. Holistic functioning:

processing multisensory input

simultaneously to provide

“holistic’ picture of one

environment.

2. Visual spatial skill

3. Dancing and gymnastic

4. Memory is stored in auditory,

visual and spatial modalities

http://www.thethinkingbusiness.com/brain_zone/brain-tour/brain-hemispheres

What is neuroplasticity?

Define as “ the ability of the brain to change and

repair itself.”

Mechanism of neuroplasticity?

Neuroanatomical Neurochemical

Neuroreceptive

changes Physical Rehabilitation: Chapter 13 Strategies to improve motor function, page

483

(i) Spontaneous recovery

Occur immediately after the

insult.

It influenced by diaschisis -

the return to function of

undamaged parts of the

brain with the resolution of

temporary blocking factors.

(i.e., shock, edema,

decreased blood flow,

decrease glucose utilization).

(ii) function-

induced recovery

The neural

organization that

occurs as a result

of increased use of

involved body

segments in

behaviorally

relevant tasks.

Physical Rehabilitation: Chapter 13 Strategies to improve motor function, page 483

Types of stroke

1. Ischemic stroke

Most common type

A clot blocks and impairs blood flow, cause lack of

oxygen and nutrients to the brain

Embolism stroke –

blood clot travel to the brain

Thrombosis stroke –

blood flow is blocked to the brain

Physical Rehabilitation: Chapter 18 stroke, page 705

2. Hemorrhagic stroke

Blood vessel rupture, causing leakage of blood in or

around the brain

Physical Rehabilitation: Chapter 18 stroke, page 705

Controllable Uncontrollable

High blood pressure

Artrial fibrillation

High cholestrol

Diabetes

Atherosclerosis

Circulation problems

Tobacco used and smoking

Alcohol use

Physical inactivity

Obesity

Age Gender Race Family history Previous stroke/ TIA Fibromuscular

Dyslapsia Patent Foramen Ovale

(PFO or hole in the heart)

http://www.stroke.org/site/PageServer?pagename=RISK

http://neuro4students.wordpress.com/pathophysiology/

http://neuro4students.wordpress.com/pathophysiology/

1. Sudden numbness or weakness of the

face, arm, or leg, especially on one side of

the body.

2. Sudden confusion, trouble speaking or

understanding.

3. Sudden trouble seeing in one or both eyes.

4. Sudden trouble walking. Dizziness, loss of

balance or coordination.

5. Sudden, severe headaches with no known

cause.

Physical Rehabilitation: chapter 18 Stroke, page 707

Hemorrhagic stroke

Drugs and blood transfusion product that

clot the blood.

Surgical blood vessel repair

1. Surgical clipping

2. Coiling (endovascular embolization)

3. Surgical AVM removal

http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=treatments-and-

drugs

Ischemic stroke

Therapy with clot-busting drugs (within 4.5hours)

Example: heparin, warfarin (Coumadin), aspirin, or

clopidogrel (Plavix).

Intravenous injection of tissue plasminogen

activator (TPA) – restore blood flow by dissolving

blood clot.

Emergency procedures

1. Medication delivered directly into the brain.

2. Mechanical clot removal

Other procedures:

1. Carotid endarterectomy

2. Angioplasty and stents http://www.mayoclinic.com/health/stroke/DS00150/DSECTION=treatments-and-

drugs

Improve balance and walking.

Increase ability to roll/move in bed/sit/stand

Reduce muscle spasms, pain and stiffness

Increase strength

Retrain normal patterns of movement

Increase affected arm and leg function

Increase energy levels

Increase independence and quality of life

Reduce the risk of falls http://www.manchesterneurophysio.co.uk/stroke/physiotherapy-treatment-cva.html