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Stroke, pusher syndrome, other - Coggle Diagram

- - - - improve functional performance
      - Other interventions
        
        bilateral training
        
        CIMT
        
        VR
        
        electromechanical-assisted walking
    - - task-oriented approach
      - Gait training
      - Motor control
      - Tone normalization
    - - ROM exercise
      - Upright posture and functional mobility
        activity
      - Muscle strengthening
      - Position as early as possible
  - - - robot assisted LT
      - PWBSTT
    - - VR
      - mirror therapy
      - motor imagery
      - action observation
      - NMES & EMG biofeedback
      - CIMT
- - - - detection of cerebral infarction within 2~6 hours
    - - identify vascular abnormalities and alterations in blood flow
    - - rule out other brain lesions
    - - imaging the neck and chest vessels and assessing the degree of stenosis in vessels
  - - - Test：NIHSS
    - - Cerebral hemorrhage
      - Subarachnoid hemorrhage
      - Embolus
    - - BP/RR/HR
  - - - Thrombolytic therapy
    - - Mechanical thrombectomy
      - Carotid endarterectomy
- - - - Functional Disability
        
        ADL/BADL /IADL
        
        Measures
        
        BarthelIndex
        
        FIM
      - Postural Control and Balance
        
        Balance control in sitting and standing
        
        Dynamic
        
        Tests
        
        PASS
        
        The Romberg Test
        
        Berg Balance Scale
        
        Functional Reach
        
        Functional Balance Grade
        
        Test
        
        Balance strategy
        
        Functional assessment
        
        Static
        
        Postural alignment
    - - Motor Planning (Higher-Order Cognition) Deficits
        
        Motor apraxia
        
        Ideomotor
        
        Ideational
      - Affective Dysfunction
        
        Pseudobulbar affect (PBA)
        
        Lesion sites
        
        frontal lobe
        
        limbic system
        
        hypothalamus
        
        Anxiety
        
        Apathy
        
        Depression
        
        Euphoria
      - Perceptual and cognitive function
      - Consciousness
        
        GCS
      - memory defect
        
        JOMAC, MMSE
    - - Dysphagia
    - - Muscle tone and reflexes
        
        Flaccidity (hypotonicity)
        
        Hyperreflexia
        
        Spasticity (hypertonicity)
        
        increase in DTR
        
        Clonus
        
        TEST
        
        DTR
        
        MAS
      - Movement coordination
        
        criteria
        
        speed control
        
        steadiness
        
        response orientation
        
        reaction and movement time
        
        test
        
        Non-equilibrium test
        
        equilibrium test
      - Muscle performance
        
        hemiparesis
        
        Test
        
        Brunnstorm stage
        
        Synergy Movement
        
        Extensor synergy
        
        Flexor synergy
        
        Abnormal Reflexes
        
        Associated reactions
        
        Raimiste’sphenomenon
        
        MMT
        
        Fugl-Meyer Assessment
      - Voluntary movement patterns
        
        Hemiplegia
    - - Facialpalsy
        
        Peripheral type
        
        CN VII
        
        Central type
        
        motor cortex or descending pathway
    - - Visual Disturbances
        
        Homonymous hemianopsia
        
        Diplopia
        
        Deficits in oculomotor control
        
        Poor visual acuity
        
        test
        
        Doll’s eye sign
        
        EOM test
        
        Accommodation reflex(CN3.4.6)
        
        Pupillary light reflex (CN3)
        
        Cortical blindness
      - CPSP
      - anesthesia
        
        test
        
        Combined cortical sensation
        
        Superficial sensation
        
        Deep sensation
    - - Language Deficits
        
        test
        
        MMSE
        
        dysarthria
        
        fluency
        
        articulation
        
        naming
        
        Repetition
        
        comprehension
        
        Dysarthria
        
        Dysphonia
        
        Aphasia
        
        Wernicke
        
        Global
        
        Broca
        
        Conduction
- - - - Ischemic
        
        Thrombosis
        
        Etiology
        
        Atherosclerosis
        
        Common caotid artery
        
        Cerebral artery
        
        Basilar artery
        
        HT
        
        ABI
        
        Hypoperfusion
        
        Etiology
        
        Cardiac failure
        
        blood loss
        
        Embolus
        
        Etiology
        
        SLE
        
        Blood clot、tissue、fat、bacteria
        
        Embolus from cardiovascular system
      - Hemorrhagic
        
        SAH
        
        ICH
        
        Etiology
        
        Trauma
        
        Ruptured AVM
        
        HT
        
        AVM
    - - PCA
        
        memory
        
        centrak poststroke
        
        weber's syndrome
      - ACA
        
        LE
        
        urinary incontinence
        
        apraxia
      - ICA Syndrome
        
        Complete occlusion
        
        Incomplete occlusion
      - Lacunar syndrome
        
        dysarthria/clumsy hand syndrome
        
        ataxic hemiparesis
        
        Pure sensory lacunar stroke
        
        dystonia/involuntary movements
        
        Pure motor lacunar stroke
      - VBA Syndrome
        
        Numbness or tingling
        
        Slurred or lost speech
        
        Drop attack
        
        Confusion
        
        Visual disturbances
        
        ◦ Issues with swallowing
        
        Vertigo
        
        Wallenberg’s syndrome
      - BA Syndrome
        
        diplopia
        
        progressive quadriplegia
        
        Occipital headache
        
        bulbar paralysis
        
        coma
        
        Locked-in syndrome
        
        lower bulbar paralysis
        
        preserve
        
        consciousness
        
        vertical eye movement and blinking
        
        Quadriplegia
      - Subclavian Steal Syndromes (Subclavin Artery Narrowing)
        
        May not cause symptoms
        
        (ipsilateral) limb ischemia
        
        vertebrobasilar insufficiency
      - MCA
        
        aphasia
        
        perceptual deficit
        
        UL
  - - - Hypertension
      - DM
      - cardia disorder
      - RHD
      - AF
      - Excessive alcohol / Smoke
      - Obesity
    - - Hx
      - Age
      - Gender
      - Race
- - - - ICH 82%
      - SAH 46%
      - Cerebral embolus 16%
      - atherothromboticinfarction 15%
    - - The large the lesion, the more widespread the impairment of brain function
- - - - intervention & prevention
        
        FES
        
        taping
        
        active exercise & task-oriented training
        
        avoid damaging event
        
        avoid prolonged GH joint IR / add
        
        appropriate positioning
      - 3 phases
        
        3 atrophic (final)
        
        hand contracture (MP ext.+ IP flex)
        
        progressive atrophy(skin muscle bone)
        
        2 dystrophic phase (later)
        
        early osteoporosis
        
        hyperhydrosis
        
        subsiding pain
        
        1 acute phase (early)
        
        hypersensitive (touch, pressure, temperature)
        
        temperature and skin color change(pale cool / pink)
    - - ex: GHS
        
        posterior subluxation
        
        anterior subluxation