Certified
Stroke
Rehabilitation
Specialist
(CSRS
2024)
Types
of
stroke
(Lesson
2)
-
ANSWER-Ischemic:
87%
-Thrombotic
-Embolic
-Lacunar
Hemorrhagic:
13%
-Intracerebral
-Subarachnoid
Thrombotic
Stroke
(Ischemic)
-
ANSWER-48%
of
all
strokes
-typically
occurs
during
sleep
-slow
progressive
onset
of
deficits
-50%
are
associated
with
prior
TIA
Embolic
Stroke
(Ischemic)
-
ANSWER-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
-
ANSWER-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)
-
ANSWER-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)
-
ANSWER-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
-
ANSWER--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)
-
ANSWER--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
-
ANSWER-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)
-
ANSWER--fast
and
impulsive
-short
attention
span
-overestimate
abilities/
judgement
-denial
of
illness
(anosognosia)
-lack
of
inhibition
-inability
to
express
emotions
/affect
is
flat
Cerebrum
-
ANSWER--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
-
ANSWER--controls
voluntary
movement
-thinking
problem
solving
-reasoning
judgement
-personality
Primary
Motor
Cortex
(motor
homunculus)
-
ANSWER--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
-
ANSWER--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
-
ANSWER--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
-
ANSWER-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
-
ANSWER-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
-
ANSWER-A
region
of
the
cerebral
cortex
whose
functions
include
processing
information
about
touch.
-perception
-processing
of
sensation
-spatial
awareness
Somatosensory
Cortex
-Sensory
Homunculus
-
ANSWER-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
-
ANSWER-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
-
ANSWER-A
region
of
the
cerebral
cortex
that
processes
visual
information
-contain
two
important
regions
-Primary
Visual
Cortex
-Visual
Association
Area
Primary
Visual
Cortes
(
Occipital
Lobe)
-
ANSWER-Responsible
for:
-visual
perception
-receiving
visual
input
from
the
contralateral
visual
field
Damage
results
in:
-hemianopsia:
injury
on
one
side
-cortical
blindness
:
bilateral
injury
-qudrantanopia:
anopia
affecting
a
quarter
of
the
field
of
vision.
(describes
defects
confined
mostly
to
approximately
one-fourth
of
an
eye's
visual
space)
Visual
Association
Area
(Occipital
Lobe)
-
ANSWER-Located
anterior
to
the
primary
visual
cortex
Responsible
for:
-interpretation
of
visual
stimuli
(spatial
perception
&
recognition
of
faces)
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