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While the deficits that occur is highly dependent on exactly which artery was
affected by the CVA; it is important to remember that most deficits will occur on the
opposite side from where the CVA occurred. The following is a list of expected
deficits for each hemisphere of the brain.
LEFT HEMISPHERE
Aphasia & communication deficits
Confusion of Time
Decreased Problem Solving
Dressing Apraxia
Info. Processing Delays
Poor Right/Left Discrimination
Easily Frustrated
Underestimate abilities
Inability to Communicate through Writing
Right Sided Paresis or Plegia
RIGHT HEMISPHERE
Visual field deficits/neglect
Poor Insight & Judgement
Spatial-perceptual analysis deficits
Disorientation
Emotional Lability
Decreased Attention Span,
Increased Verbalizations
Decreased Motivation
Body Schema Perception Disorders
Left Sided Paresis or Plegia
As healthcare professionals it is be our job to help our patients overcome the effects
of the CVA as best as possible. Part of our role is to educate the patient and
caregivers with information that will help them adjust to this condition. One
resource for caregivers and CVA patients is www.mystrokecaregiver.com.
Many patients who suffer a CVA are at greater risk for a glenohumeral subluxation
(shoulder dislocation). As a healthcare team is our job to make sure the patient is
safe and protected from this condition. Muscle tone is often affected following a
CVA, and subluxation is often the result of low muscle tone and improper positioning
or transfer techniques.
It is common following a stroke for the patient to experience different amounts of
muscle tone. Tone is the normal resting tension within a muscle. Soon after a CVA it
is common to be flaccid or hypotonic (low tone). As more time passes it is common
for the patient to experience hypertonicity or spasticity (high tone). It is also
common for some muscles to be hypotonic while others are hypertonic. Bed and
wheelchair positioning should either increase or decrease tone.
For wheelchair positioning a trough is recommended for patients experiencing high
tone. The affected side should be placed in the trough,
palm down, and hand open. A restraint may be necessary
to
hold extremity in position. Patient should be taught how to
release restraint. A patient experiencing low tone should
be
fitted with a tray that supports the elbow. The fingers are
closed around an object (which may need to be strapped in
place) with the thumb pointing up. Instruct patient on how
to
remove the strap holding the item in hand. Trays and
troughs DO NOT need to be removed during transfers.