6
- Possible in white matter
Possible deficits
- Dysarthria/clumsy hand syndrome
- Ataxic hemiparesis
- Sensory/motor
- Dystonia/involuntary movements (choreoathetosis, hemiballismus)
Lacunar stroke
Acute hemiparesis rapidly progressing to tetraplegia and lower bulbar paralysis - the patient cannot move or speak but remains alert and oriented. Horizontal eye movements are impaired but vertical eye movements and blinking remain intact
Locked in syndrome (vertebrobasilar artery syndrome)
What are the (3) types of aphasia?
1. Brocas/non fluent/expressive
2. Wernickes/fluent/receptive
3. Global
Majority on the L, posterior temporal lobe; patient responds with words/sentences that do not relate to the therapists questions; receptive aphasia; clear speech
Wernicke's aphasia
Inability to recognize or make sense of information despite intact sensory capabilities
Agnosia
Possible deficits:
- Occlusions can produce a wide variety of symptoms with both ipsilateral and contralateral signs because some of the tracts in the brainstem will have crossed and other will not
- Locked in syndrome
Vertebrobasilar artery syndrome
What are the (3) types of speech, language and swallowing deficits?
1. Aphasia
2. Dysarthria
3. Dysphagia
What are the (3) types of agnosia?
1. Visual
2. Auditory
3. Tactile/astereognosis
Not understanding and not speaking or reacting
Global aphasia
Difficulty swallowing
Dysphagia
Patient makes sound, but appears to form some words, may communicate with picture board, motor aphasia, L MCA damage, expressive aphasia
Broca's aphasia
Issues with producing speech from the muscles of the jaw; motor production of speech
Dysarthria
Patient can see, but cannot recognize what is object is; cant make sense of environment, processing issue
Visual agnosia
Can feel what they are touching, but cannot recognize what they are touching despite an intact system
Tactile/astereognosis
Hearing is fine... but cannot understand what they are hearing
Auditory agnosia
Inability to perform purposeful movement despite intact abilities
Apraxia
Unable to perform on command, but can at other times
EX: Does not stand on command, but when family comes to greet them they stand up
Ideomotor apraxia
Inability to register and integrate stimuli and perceptions from one side of the body or environment
- Very common in damage to the R side of the brain
- can teach them to become aware of this side
Neglect
What are the (2) types of apraxia?
1. Ideomotor
2. Ideational
Does not understand concept (EX: brushing teeth)
EX: Give them toothbrush and toothpaste, but do not put it together; may put toothpaste in hair
Ideational apraxia
Lack of awareness, or denial, of a paretic extremity as belonging to the person, or a lack of insight concerning, or denial of, paralysis and disability
- They do not believe that the arm is weak or their arm
- Denial something is going on on that side
- Prognosis is very poor for safety, WC bound, caregiver may be needed
Anosognosia
With a homonymous hemianopsia which (2) areas of the brain are affected?
1. Optic tract
2. Optic radiation
For the right visual field, which part of the eyes are taking in this information?
L temporal, R nasal
For the left visual field, which part of the eyes are taking in this information?
R temporal, L nasal
- Impaired motor function
- Impaired sensory function
- Altered LOC
- Cognitive deficits
- Affective status - pseudobulbar affect
Deficits in stroke