Neurological Sequelae of Stroke

diasabilites observed at 6mo post stroke in survivors over 65 yrs

hemiparesis, inability to walk without assistance, dependence with ADLs, aphasia, depression

Neurological sequelae (13 symptoms)

altered consciousness, speech and language, dysphagia, cognitive, perceptual, sensory, motor, seizures, affective, bowel and bladder, cardiovascular and pulmonary, D VT, osteoporosis and Fx risk

used to measure arousal level

glasgow coma scale

glasgow coma scale

• lowest score = ____

• highest score = ____

3, 15

speech and language deficits 

• ____ - impairment in language comprehension, formulation and use 

• ____ - motor disorder 

aphasia, dysarthria 

dysphagia

• difficulty ____

• _____

  • can lead to ____ distress

  • will determine ___ precautions

swallowing, aspiration, respiratory, NPO

cognitive deficits

• _____, disorientation, attention, ____, confabulation, ______, preservation

• executive functions: ____, inflexible thinking, lack of ____ thinking, impaired ____ or _____, decreased ____, impaired _____ and impaired judgement

• vascular ____

• _____

alertness, memory, confusion, impulsiveness, abstract, organization, sequencing, insight, dementia, delirium

perceptual deficits

• body ___/____

  • unilateral ____, _____, somatagnosia, ____ discrimination, finger agnosia

• _____ relations

  • figure-ground _____, form ____, position in _____, _____ disorientation

scheme, image, neglect, anosognosia, right-left, spatial, discrimination, discimination, space, topographical

anosognosia = 

denies their neuro/psych symptoms 

somatagnosia =

impairment of body scheme

figure-ground discrimination =

inability to distinguish object from background

form discrimination =

inability to perceive difference between objects

topographical disorientation =

differentiate between stimuli based on physical location

agnosia = 

inability to interpret sensation 

sensory deficits

• _____, ____, ____

stereognosis, kinesthesia, graphesthesia

stereognosis =

ability to identify object with touch alone

kinesthesia =

awareness of position/movement

graphesthesia =

recognize numbers, letters, or symbols written on skin

motor deficits 

• _____

• _____

• typically on side of body _____ the lesion 

paralysis, weakness, opposite 

affective status

• pseudobulbar affect (aka emotional _____)

• _____, euphoria, _____

liability, apathy, depression

bowel and bladder dysfunction

• uninary incontinence d/t bladder ____ or _____, disturbances in ____ control and/or ____ loss

• fecal ____, diarrhea, _____, impaction

hyperreflexia, hyporeflexia, sphincter, sensory, incontience, constipation

cardiovascular and pulmonary dysfunction

• underlying ____

• deconditioning

• decreased _____ output

CAD, respiratory

DVT and pulmonary embolus 

• potential complication for all ______ pts 

• risk is high in ____ phase due to ____, limb ____, hemineglect, and impaired ____ status 

immobilized, acute, immobility, paralysis, congitive 

osteoporosis and fracture risk

• increased risk of ____ or ____ fx d/t osteoporosis and fall risk

vertebral, hip

measures stroke severity

NIH stroke scale

NIH stroke scale 

• mild = _____

• mind to moderately severe = _____

• severe = _____

• very severe = _____

1-5, 5-14, 15-24, >25