Question re: CVA

[megananne7]

I went to my Per Diem job today for a meeting (they are switching pharmacies and wanted everyone on the same page). I walked over to the Alzheimers unit to put something in someone's mailbox and one of the CNAs over there told me about one of the residents who wasn't acting like herself.

I checked her out really quick. BP was 204/186, staring off into space, not following commands, not speaking just making mumbly noises every so often. To me, I figured she was having a CVA. One of the other nurses (actually, the DON) came over and said something like CVA patients "looking toward or away from the stroke... I cant remember which tho". I had never heard anything like this (new nurse).

Is this true or just an old wives tale? And if it is true, which do direction do they tend to stare at... toward the side that the stroke is occurring or in the opposite direction of the stroke?

[labman]

I remember with strokes they usually look at the direction of the stroke.

I remember this as Left stroke (Right side flaccid). They neglect their flaccid side and stare at the side that they can use. I am pretty sure this is correct. Someone correct me if I am wrong

[megananne7]

Well, she was staring off to the left and up. Not responding to her name, phrases she always says. Neither side was really flaccid. She was just totally non responsive. I tried to get her to follow commands I gave her (smile, stick out tongue, squeeze fingers) and got no response.

[chadash]

http://www.mdchoice.com/emed/main.asp?template=0&page=detail&type=8&id=939

This is an emergency medicine article that is very thorough in assessing strokes.

You might read through this...sure you will have a far better grasp than I:smokin:!

... the patient will look away from the hemiparesis with a frontal lobe stroke and toward the hemiparetic side with a pontine infarct or seizure....

Seems like different strokes for different folks..

[leslie :-D]

You might read through this...sure you will have a far better grasp than I:smokin:!

... the patient will look away from the hemiparesis with a frontal lobe stroke and toward the hemiparetic side with a pontine infarct or seizure....

Seems like different strokes for different folks..

hahahahahaha.

very cute, chadash.

leslie

[aeauooo]

Is this true or just an old wives tale? And if it is true, which do direction do they tend to stare at... toward the side that the stroke is occurring or in the opposite direction of the stroke?

Eyes deviate away from an irritative lesion (seizure focus), towards a destructive lesion (stroke)

"Gaze preference deviation:

a. A right gaze deviation is due to a right hemispheric lesion, left hemispheric irritative focus (i.e. seizure), or a left brainstem lesion.

b. A left gaze deviation is due to a left hemispheric lesion, right hemispheric irritative focus, or a right brainstem lesion"

AANN Core Curriculum for Neuroscience Nursing, 4th Edition

Incidentally, 'stroke' is now preferred term, rather than 'CVA.'

See you in Nashville!

[Scrabbler]

Eyes deviate away from an irritative lesion (seizure focus), towards a destructive lesion (stroke)

"Gaze preference deviation:

a. A right gaze deviation is due to a right hemispheric lesion, left hemispheric irritative focus (i.e. seizure), or a left brainstem lesion.

b. A left gaze deviation is due to a left hemispheric lesion, right hemispheric irritative focus, or a right brainstem lesion"

AANN Core Curriculum for Neuroscience Nursing, 4th Edition

Incidentally, 'stroke' is now preferred term, rather than 'CVA.'

See you in Nashville!

Is that because "accidents can be prevented"?

[aeauooo]

Is that because "accidents can be prevented"?

Very good, but not quite.

As I recall, the thinking is that accidents can't be prevented, but strokes can. Besides, the lay public understands the term 'stroke.'

FWIW, I never liked the term "brain attack."