2. 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)

3. Anatomy of the brain

4. 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

5. 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

6. 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

10. 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

11. (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

12. 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

13. 2. Hemorrhagic stroke
Blood vessel rupture, causing leakage of blood in or
around the brain
Physical Rehabilitation: Chapter 18 stroke, page 705

14. 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

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

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

17. 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

18. 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

19. 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

20. 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