PTA Stroke (CVA) Exam: Key Concepts and Neurovascular Deficits

CVA (Cerebrovascular Accident)

Loss of blood flow to the brain resulting in neurological deficits.

Ischemic Stroke

Most common (~87%); Blood clot blocks artery; Brain tissue deprived of oxygen.

Hemorrhagic Stroke

Bleeding into or around brain; Often associated with hypertension or aneurysm rupture.

TIA (Transient Ischemic Attack)

Temporary neurological symptoms; No permanent infarction; Warning sign for future stroke.

AV Malformation (AVM)

Congenital abnormal connection between arteries and veins; Can rupture causing hemorrhagic stroke.

Hemiparesis

Weakness on one side.

Hemiplegia

Paralysis on one side.

Broca's Aphasia (Expressive)

Nonfluent speech; Good comprehension; Frustrated because they know what they want to say.

Wernicke's Aphasia (Receptive)

Fluent speech; Poor comprehension; Speech often meaningless.

Global Aphasia

Poor expression; Poor comprehension; Most severe.

Dysarthria

Motor speech disorder; Slurred speech; Weak speech muscles; Language intact.

Dysphagia

Difficulty swallowing; Risk of aspiration and pneumonia.

Apraxia

Cannot perform learned movement despite adequate strength.

Agnosia

Can see object but cannot identify it.

Homonymous Hemianopsia

Loss of half the visual field in both eyes.

LEFT CVA

RIGHT side weakness; Common findings include aphasia, apraxia, depression, slow cautious behavior, and awareness of deficits.

RIGHT CVA

LEFT side weakness; Common findings include unilateral neglect, poor judgment, impulsive behavior, safety risk, denial of deficits, and distractibility.

Unilateral Neglect

Usually RIGHT hemisphere damage; Patient ignores LEFT side.

MCA (Middle Cerebral Artery)

Most common stroke; Affects face and upper extremity more than leg.

ACA (Anterior Cerebral Artery)

Affects lower extremity more than arm.

Locked-In Syndrome

Cause: Basilar artery stroke; Patient is awake, alert, can move eyes, but cannot move body.

Pusher Syndrome

Patient actively pushes toward involved side; Resists correction.

Pseudobulbar Affect

Uncontrollable crying or laughing; Not consistent with actual emotions.

Flaccidity

Early after stroke; Low tone; Limp.

Spasticity

Later after stroke; Hypertonicity; Increased resistance to movement.

UE Flexor Synergy

Pattern includes scapular retraction, shoulder abduction, shoulder external rotation, elbow flexion, forearm supination, wrist flexion, and finger flexion.

LE Extensor Synergy

Pattern includes hip extension, hip adduction, hip internal rotation, knee extension, ankle plantarflexion, and ankle inversion.