by Natalie I. Kelly

Created on: September 17, 2011   Last Updated: September 19, 2011

A stroke or sometimes termed cerebrovasular accident (CVA) is a condition affecting the brain that causes neurological dysfunctions.

Anatomy of the Brain

In order for the brain to function is requires oxygen and nutrients.  This is supplied through a dense network of blood vessels.  There are two major vessels that supply the brain: the carotid and vertebral arteries.  The carotid supplies the front of the brain, while the vertebral supplies the back of the brain, the cerebellum and brainstem.  The cerebellum is the hindpart of the brain (or the base of the head) that is responsible for balance, coordination, posture, and eye movement.  Below the cerebellum is the brain stem (the junction of the head and upper neck), this is where the brain connects with the spinal cord.

What is a Stroke?

When blood flow is affected it causes brain cells to die and brain damage to occur.  Therefore, if you think of the blood vessels like a garden hose, if there is a kink in the hose water will not flow.  In the case of a stroke, if blood flow is occluded it results in brain damage or cell death. 

The extent of the damage is dependent on which vessels are affected and how large the occlusion of blood flow to the brain.

The more serious or deathly strokes involve large occlusions in the vertebral arties. 

The neurological deficits typically affect one side of the body.  Possible deficits are impairments in sensation, motor (or muscle strength), cognitive, perceptual, and language functions. 

The deficits need to be present for more than 24 hours to be considered a stroke. 

Neurological Deficits

Motor impairments can involve either muscle weakness or complete paralysis.  Also, motor affects how a person coordinates moving, posture, and balance.

Perceptual impairments affect the body image.  An individual may be unaware of one side of the body or termed right and left sided neglect.  If an individual suffers left sided neglect they are unable to recognize information coming from the left.  Therefore, if standing on a person’s left they are unaware and do not respond to any stimulus. 

Another perceptual impairment is not having a sense of mid-line.  The person will lean to one side, typically the unaffected side.  If you attempt to right the person or force them to put weight on the affected side they may push or fight as they perceive themselves as falling.

Cognitive impairments affect attention and memory.

Speech impairments can involve an inability to talk, but able to comprehend.  Or comprehension is affected, resulting in slow speech and inability to following commands. 

An Acute Stroke

An acute stroke is a severe, critical, and brief time period.  It is the time of onset to the few hours that follow.  It’s the period of urgency in seeking care to minimize impairments and prevent death.

Carr, Janet H., and Roberta B. Shepard. Nuerological Rehabilitation: Optimizing Motor Performance.  Butterworth-Heinemann, 1998.

O’Sullivan, Susan B., and Thomas J. Schmitz. Physical Rehabilitation Assessment and Treatement.  F. A. Davis Company, 2000.

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