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ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM. Assessment of a CVA F.A.S.T F ace A rms S peech T ime * *http://www.stroke.org/site/News2?page=NewsArticle&id=9015&news_iv_ctrl=1222. Cerebrovacular Accident Neurological Assessment. Cognitive Motor Sensory Cranial Nerve Function
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ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM Assessment of a CVA F.A.S.T Face Arms Speech Time* *http://www.stroke.org/site/News2?page=NewsArticle&id=9015&news_iv_ctrl=1222
Cerebrovacular Accident Neurological Assessment • Cognitive • Motor • Sensory • Cranial Nerve Function • Cardiovascular assessment • Psychosocial assessment
Cognitive Assessment • Intellectual Function -memory -judgment -problem solving/ decision making -speech
Motor Assessment • Motor changes -hemiplegia (paralysis) -hemiparesis (weakness) -muscle tone (hyper or hypotonia) -motor activity (agnosia/ apraxia) -bowel/bladder control -gag reflex/ swallowing -self care
Sensory Assessment • Sensory changes -sensory loss (touch, pain, heat, cold) -neglect syndrome -spatial/proprioceptive -hemianopsia -Amaurosis fugax
Cranial Nerve Assessment • Functional Abnormalities -Assess any difficulties in chewing, swallowing -Assess any facial paralysis
Cardiovascular Assessment • Obtain patient history: heart murmur, TIA • Assess vital signs especially BP - history of hypertension
Psychosocial Assessment • Assess patient’s reaction to illness • Assess behavioral changes: -emotional lability -mood changes ( fear, anger, depression) -assess effect on financial status, job
Hemorrhagic-SubarachnoidCerebral Aneurysm • Warning Symptoms: sudden onset of a severe headache – “worst headache of one’s life” • Change of LOC, Neurological deficits, nausea, vomiting, seizures, stiff neck • Prognosis: many patients die or left with significant cognitive difficulties
Diagnostic Tests • CAT scan • MRI/ MRA • SPECT (Single-photon emission computed tomography) • Carotid Doppler Studies • Angiography • Lumbar puncture • Glascow Coma Scale: monitor neurological status