CERTIFIED STROKE REHABILITATION
JV
SPECIALIST (CSRS 2021)
Types of stroke
(Lesson 2) - Ischemic: 87%
-Thrombotic
-Embolic
-Lacunar
Hemorrhagic: 13%
-Intracerebral
-Subarachnoid
Thrombotic Stroke (Ischemic) - 48% of all strokes
-typically occurs during sleep
-slow progressive onset of deficits
-50% are associated with prior TIA
Embolic Stroke (Ischemic) - 26% of all strokes
-typically occurs while awake
-sudden, immediate deficits (sometimes seizures)
-11% are associated with prior TIA
Lucunar Stroke (Ischemic)
small vessel disease - 13% of all strokes
-small infarct (>15-20 cm) deep in the brain
-onset can be gradual or sudden
-23% associated with proceeding TIA
-often pure sensory or motor symptoms
-typically no higher cortical functional involved
Intracerebral Hemmorhage (ICH) - 10% of all strokes
,-90% happen with the patient is under "no stress"
-major cause of "hypertension"
-onset may be gradual or sudden
-8% are associated with prior TIA
-direct correlation with high blood pressure/ hypertension
Subarachnoid Hemorrhage (SAH) - 3% of all stroke
-occurs often during strenuous activity
-cause: rupture aneurysms and vascular malformations
-sudden onset
-7% are associated with preceding TIA
Left Stroke with Right Hemiplegia - -Language/Perceptual problems
-expressive aphasia
-receptive aphasia
-global aphasia
-alexia, agraphia , acalculia
-apraxias: motor planning perceptual problems
(Impaired verbal and math skills with word letter discrimination
Left Stroke with Right Hemiplegia (BEHAVIORS) - -Slow, anxious, cautious, normal attention span
-underestimated abilities
-emotionally labile ( abrupt mood changes)
-quick to anger and/or become frustrated
Right Stroke with Left Hemiplegia - Perceptual problems/ Distortion of physical reality
-visual spatial disorders :depth perception
-constructional relationships
-directional concepts
-neglect, drawing abilities
-body schema perception disorders;
-perceptual language disorders
language
,Right Stroke with Left Hemiplegia (BEHAVIORS) - -fast and impulsive
-short attention span
-overestimate abilities/ judgement
-denial of illness (anosognosia)
-lack of inhibition
-inability to express emotions /affect is flat
Cerebrum - -frontal, parietal, temporal, and occipital lobes
-consisting of two hemispheres, left and right, separated by a fissure
-responsible for the integration of complex sensory and neural functions and the initiation and
coordination of voluntary activity in the body.
initiates and coordinates movement and regulates temperature. Other areas of the cerebrum enable
speech, judgment, thinking and reasoning, problem-solving, emotions and learning.
Frontal Lobe - -controls voluntary movement
-thinking problem solving
-reasoning judgement
-personality
Primary Motor Cortex
(motor homunculus) - -located on the pre-central gyrus
-controls voluntary movement
-lesion to this area results in motor deficits and/or paralysis to the contralateral side of the body
Premotor Cortex - -located just anterior to the primary motor cortex
-controls actions of trunk and proximal limb muscles
-responsible for body part ownership
-lesion to this area result in unilateral neglect
Supplementary Motor Cortex - -located medial to the primary motor cortex
-motor planning region
-stores motor memories and directs activity of primary motor cortex
-lesion may result in apraxia
Broca's Area - Controls language expression - an area of the frontal lobe, usually in the left hemisphere,
that directs the muscle movements involved in speech.
, -Speech motor area (expressive)
-located only in the left side of the brain in 90% of people
-can be flipped with left -handed people
Wernike's Area - language comprehension
-located in the left hemisphere in 90% of people
-important for understanding language including: verbal sign and written language
-corresponding area contralaterally responsible for interpretation of nonverbal communication
-damage results in receptive aphasia (
Parietal Lobe - A region of the cerebral cortex whose functions include processing information about
touch.
-perception
-processing of sensation
-spatial awareness
Somatosensory Cortex
-Sensory Homunculus - area at the front of the parietal lobes that registers and processes body touch
and movement sensations (Brodmann area 1,2, 3a and 3b)
-located on the postcentral gyrus
-perceives pain, temperature, pressure
-touch, vibration, and proprioception
Parietotemporal Association Cortex - located:
-posterior and inferior portion of the parietal lobe
-overlaps parietal and temporal lobe
-involved in abstract thought, reading and writing
-mathematics, spatial perception
-understanding written language (angular gyrus)
Occipital Lobe - A region of the cerebral cortex that processes visual information
-contain two important regions
-Primary Visual Cortex
-Visual Association Area
JV
SPECIALIST (CSRS 2021)
Types of stroke
(Lesson 2) - Ischemic: 87%
-Thrombotic
-Embolic
-Lacunar
Hemorrhagic: 13%
-Intracerebral
-Subarachnoid
Thrombotic Stroke (Ischemic) - 48% of all strokes
-typically occurs during sleep
-slow progressive onset of deficits
-50% are associated with prior TIA
Embolic Stroke (Ischemic) - 26% of all strokes
-typically occurs while awake
-sudden, immediate deficits (sometimes seizures)
-11% are associated with prior TIA
Lucunar Stroke (Ischemic)
small vessel disease - 13% of all strokes
-small infarct (>15-20 cm) deep in the brain
-onset can be gradual or sudden
-23% associated with proceeding TIA
-often pure sensory or motor symptoms
-typically no higher cortical functional involved
Intracerebral Hemmorhage (ICH) - 10% of all strokes
,-90% happen with the patient is under "no stress"
-major cause of "hypertension"
-onset may be gradual or sudden
-8% are associated with prior TIA
-direct correlation with high blood pressure/ hypertension
Subarachnoid Hemorrhage (SAH) - 3% of all stroke
-occurs often during strenuous activity
-cause: rupture aneurysms and vascular malformations
-sudden onset
-7% are associated with preceding TIA
Left Stroke with Right Hemiplegia - -Language/Perceptual problems
-expressive aphasia
-receptive aphasia
-global aphasia
-alexia, agraphia , acalculia
-apraxias: motor planning perceptual problems
(Impaired verbal and math skills with word letter discrimination
Left Stroke with Right Hemiplegia (BEHAVIORS) - -Slow, anxious, cautious, normal attention span
-underestimated abilities
-emotionally labile ( abrupt mood changes)
-quick to anger and/or become frustrated
Right Stroke with Left Hemiplegia - Perceptual problems/ Distortion of physical reality
-visual spatial disorders :depth perception
-constructional relationships
-directional concepts
-neglect, drawing abilities
-body schema perception disorders;
-perceptual language disorders
language
,Right Stroke with Left Hemiplegia (BEHAVIORS) - -fast and impulsive
-short attention span
-overestimate abilities/ judgement
-denial of illness (anosognosia)
-lack of inhibition
-inability to express emotions /affect is flat
Cerebrum - -frontal, parietal, temporal, and occipital lobes
-consisting of two hemispheres, left and right, separated by a fissure
-responsible for the integration of complex sensory and neural functions and the initiation and
coordination of voluntary activity in the body.
initiates and coordinates movement and regulates temperature. Other areas of the cerebrum enable
speech, judgment, thinking and reasoning, problem-solving, emotions and learning.
Frontal Lobe - -controls voluntary movement
-thinking problem solving
-reasoning judgement
-personality
Primary Motor Cortex
(motor homunculus) - -located on the pre-central gyrus
-controls voluntary movement
-lesion to this area results in motor deficits and/or paralysis to the contralateral side of the body
Premotor Cortex - -located just anterior to the primary motor cortex
-controls actions of trunk and proximal limb muscles
-responsible for body part ownership
-lesion to this area result in unilateral neglect
Supplementary Motor Cortex - -located medial to the primary motor cortex
-motor planning region
-stores motor memories and directs activity of primary motor cortex
-lesion may result in apraxia
Broca's Area - Controls language expression - an area of the frontal lobe, usually in the left hemisphere,
that directs the muscle movements involved in speech.
, -Speech motor area (expressive)
-located only in the left side of the brain in 90% of people
-can be flipped with left -handed people
Wernike's Area - language comprehension
-located in the left hemisphere in 90% of people
-important for understanding language including: verbal sign and written language
-corresponding area contralaterally responsible for interpretation of nonverbal communication
-damage results in receptive aphasia (
Parietal Lobe - A region of the cerebral cortex whose functions include processing information about
touch.
-perception
-processing of sensation
-spatial awareness
Somatosensory Cortex
-Sensory Homunculus - area at the front of the parietal lobes that registers and processes body touch
and movement sensations (Brodmann area 1,2, 3a and 3b)
-located on the postcentral gyrus
-perceives pain, temperature, pressure
-touch, vibration, and proprioception
Parietotemporal Association Cortex - located:
-posterior and inferior portion of the parietal lobe
-overlaps parietal and temporal lobe
-involved in abstract thought, reading and writing
-mathematics, spatial perception
-understanding written language (angular gyrus)
Occipital Lobe - A region of the cerebral cortex that processes visual information
-contain two important regions
-Primary Visual Cortex
-Visual Association Area
