Brain Fart: Whats the name of this CVA symptom?

Published

I know a lot of CVA patients have difficulty with the task of reaching for objects, and instead of grabbing the object, they attempt to grab to either side of the object... or when attempting to feed themselves, they may miss their mouths and go to the left or right of their mouth.

Specializes in neuro, ICU/CCU, tropical medicine.
my patient had a STAT CT and it was negative other than older CVAs/surgery... But the CNA who was familiar with the patient even pointed out to me today the patient still seemed different to her.

In ischemic stroke the head CT will initially be negative, then develop into hypodense areas after about 6 hours.

Negative head CT is one of the criteria for thrombolyitic therapy for ischemic stroke. If you wait for hypodense areas to appear, it's too late for thrombolysis.

Up Vote Up Vote ×
Specializes in Nursing assistant.

Ooh-ooh-ooooh!" excuse my Horshack moment...

I resorted to my own research, sorry , I was forced by fate.

This is from Stroke Rehabilitation: a collaborative approach by Robert Fawcus

Bare with me, going to try to transpose this best I can...

Dyspraxia is the inability to perform certain purposeful movements even though motor power and sensation may be normal...It is frequently associated with dominant hemisphere lesions...

You know, even a blind squirrel without multiple text books can get a nut now and again...:smokin:

I just liked the word.

just google this one, and see if it fits....

Up Vote Up Vote ×
Specializes in neuro, ICU/CCU, tropical medicine.
just google this one, and see if it fits....

Peace!

I rarely 'Google' anything because there is too much bad information on the Internet and I have access to plenty of reliable sources.

So, you're a nursing assistant interested in neuro? Good! That's how I started.

My fascination with neurological disorders began when I was a CNA working in a nursing home where I saw lots of people who had had strokes as well as a few other less common disorders.

Are you now or are you planning to go to nursing school? I hope so, if you're as ambitious as you sound. There's always a need for competent neuro nurses.

If I may, let me give you a couple of resources to look at:

The American Association of Neuroscience Nurses Clinical Practice Guidelines include neuro assessment of the older adult, care of the patient with seizures, and care of the patient with stroke: http://www.aann.org/pubs/guidelines.html

If you're really ambitious, as I hope you are, then you might want to peruse some of the articles from the Journal of Neuroscience Nursing: http://www.aann.org/ce/pdf/index.htm

As far as other resources on the web, the most reliable I have found is the National Institute for Neurological Disorders and Stroke: http://www.ninds.nih.gov

The Whole Brain Atlas is a lot of fun - if you're at all interested in neuroanatomy: http://www.med.harvard.edu/AANLIB/home.html

Up Vote Up Vote ×
Specializes in Nursing assistant.

Really interested in rehab...

The book I referenced was lay-friendly, but I think credible. More rehab oriented.

http://www.amazon.com/Stroke-Rehabilitation-Collaborative-Robert-Fawcus/dp/0632049987

But, I just pulled the word dyspraxia out of the air, and then defended it for fun. I don't have a clue! I was shocked to find there was some credibility to it!

NO nursing for me.

Up Vote Up Vote ×
Specializes in Nursing assistant.

Here you go!

heres an article from Randolph S. Marshall, MD, MS Basic and Clinical Neurosciences (29th annual Postgraduate review) on Higher Cortical Functions.

Is this credible?

Dyspraxia is an impairment in the execution of a motor act in the absence of primary weakness, sensory loss, or incoordination. When evaluated, patients with dyspraxia do not demonstrate any hemiparesis, sensory loss, or motor incoordination. Yet they are unable to execute motor acts, whether simple or complex. Dr Marshall distinguishes between several types of dyspraxia and apraxia. Ideomotor apraxia (or dyspraxia) is the inability to integrate basic sensory motor elements to achieve a simple motor goal, such as using scissors. Ideational apraxia is the inability to combine simple motor elements to achieve a complex or sequential motor act. For example, patients may have difficulty with complex acts, like dressing, which require executing tasks in a particular order. Constructional apraxia involves the inability to produce a mental image of an object in order to reproduce it on paper.

Often dyspraxia is associated with aphasia, which complicates evaluation and diagnosis. If a physician asks a patient to pantomime scissors, they may fail either because they do not comprehend the request (sensory aphasia) or lack the ability to execute the task (dyspraxia). This problem can be mitigated by having patients simply imitate a gesture that does not require the comprehension of language.

Sorry if you thought I was being aggressive (peace?) I just am interested, and like ideas.

Up Vote Up Vote ×
Specializes in neuro, ICU/CCU, tropical medicine.
Really interested in rehab...

Rehab's cool. I worked rehab as a nursing technician - it's hard work, but it's REAL nursing.

Another reason why I am hesitant to Google neurlogical topics is that half the time the majority of hits come from "Neuro Law" sites; id est, personal injury lawyers.

Hey, I don't know where you are, but give nursing school some thought.

Up Vote Up Vote ×
Specializes in Assisted Living, Med-Surg/CVA specialty.
In ischemic stroke the head CT will initially be negative, then develop into hypodense areas after about 6 hours.

Negative head CT is one of the criteria for thrombolyitic therapy for ischemic stroke. If you wait for hypodense areas to appear, it's too late for thrombolysis.

Well when he was admitted he had a negative CT.... then the STAT CT was negative. And I guess he had a repeat CT ordered to follow up from the admitting CT (the morning after his STAT CT)... that one was also negative.

Up Vote Up Vote ×
Specializes in neuro, ICU/CCU, tropical medicine.
Well when he was admitted he had a negative CT.... then the STAT CT was negative. And I guess he had a repeat CT ordered to follow up from the admitting CT (the morning after his STAT CT)... that one was also negative.

Good, it sounds like he didn't have an ischemic stroke then.

I have worked with a lot of nurses (and a few docs) who care for patients with stroke and were unaware that a negative head CT in the presence of new onset of focal neurologic deficits is indicative of ischemic stroke - so I throw that one out there whenever I can.

Up Vote Up Vote ×
Specializes in Assisted Living, Med-Surg/CVA specialty.

Yea, I work on the Stroke unit, so I am aware a negative CT doesn't necessarily mean the pt didn't have a CVA. I have to tell you when I noticed his new neuro changes I freaked and paged the MD on call. I'm glad he didn't have a CVA at that point, but I still don't understand why he displayed those changes.

Up Vote Up Vote ×
Specializes in neuro, ICU/CCU, tropical medicine.
I have to tell you when I noticed his new neuro changes I freaked and paged the MD on call.

Been there! Better safe than sorry.

I still don't understand why he displayed those changes.

Good question, lots of possible answers.

Up Vote Up Vote ×
+ Join the Discussion