CVA Overview and Treatment

Cardiovascular Accident (CVA)

• CVA is an acute vascular dysfunction with symptoms and signs corresponding to the involvement of focal areas in the brain.
• Results in upper motor neuron dysfunction (hemiplegia).
• The neurologic deficits must persist longer than 24 hours to be labeled as CVA.
• Accompanying dysfunctions include sensory disturbances, cognitive/perceptual dysfunction, visual disturbances, personality changes/intellectual changes and associated language disorders.

Objectives

• Break CVA myths
• Define CVA
• Differentiate CVA and stroke from heatstroke
• Know the signs and symptoms of CVA
• Understand medical treatment
• Understand the role of occupational therapy (OT) in treatment

Types of CVAs

• Hemorrhagic: Rupture in a weakened blood vessel in the brain.
• Ischemic: Insufficient blood flow to the brain, anoxia in brain cells.
  • Atherosclerosis: Narrowed or blocked arteries.
  • Embolic: Blood clot travels and blocks a brain artery.
• Transient Ischemic Attacks (TIAs): Temporary blockage of blood flow to brain (warning signs for a stroke).

Etiology (Causes of CVA)

• Non-modifiable risk factors: Age (even young people!), gender, race, ethnicity, heredity.
• Modifiable risk factors: Hypertension, cardiac diseases, diabetes, cigarette smoking, excessive alcohol use, illegal drug use, and lifestyle factors (e.g. obesity, physical inactivity, diet, stress).

Clinical Features and Problem Areas

• Specific locations affected (Internal carotid artery, Middle cerebral artery, Anterior cerebral artery, Posterior cerebral artery, Cerebellar artery system, Vertebrobasilar artery system)
• Possible impairments (depending on the affected area).

Medical Management

• Medical treatment is specific based on type/location of vascular lesion, severity, other medical/neurological problems.
• Early medical treatments.
• Prevention of complications (e.g. deep vein thrombosis - DVT, pulmonary embolism, pneumonia, cardiac disease).
• Client evaluation and therapist intervention is based on the medical record to help clients to adapt to their current needs.
• Neurological recovery takes time (often up to 6 months).

Aphasia

• Aphasia is an acquired communication disorder that is caused by brain damage. Types include:
  • Global Aphasia: Loss of all language skills.
  • Broca's Aphasia: Difficulty producing speech and in grammatical aspects of language.
  • Wernicke's Aphasia: Difficulty understanding spoken language and in word finding.
  • Anomic Aphasia: Difficulty retrieving words.

Dysarthria

• Articulation disorder in speech in absence of aphasia, caused by CNS dysfunction of speech musculature causing slurred, and/or thick speech.

OT Intervention

• Client-Centered Assessments: E.g. Canadian Occupational Performance Measure (COPM).
• Top-Down Approach: Evaluating role competency and meaningfulness (past, present & future roles), identifying problematic tasks and goals.
• Standardized Tools: E.g., Arnadottir Occupational Therapy Neurobehavioral Evaluation (A-ONE), Assessment of Motor and Process Skills (AMPS).

Example of Neuro-behavioral Dysfunctions (in Task Performance)

• Using a comb to brush teeth.
• Overestimating/underestimating the distance of a glass while eating.
• Trying to dress another person instead of oneself.
• Inability to find the bathroom.
• Putting socks on over sneakers.

This quiz covers the essential aspects of Cardiovascular Accident (CVA), including its definition, types, symptoms, and treatment options. Participants will learn to differentiate between CVA and other similar conditions, as well as the role of occupational therapy in recovery. Challenge your understanding and break the myths surrounding CVA.