2. ALTERATIONS OF THE CENTRAL NERVOUS SYSTEM Assessment of a CVA F.A.S.T Face Arms Speech Time* *http://www.stroke.org/site/News2?page=NewsArticle&id =9015&news_iv_ctrl=1222

3. Cerebrovacular Accident Neurological Assessment Cerebrovacular Accident Neurological Assessment  Cognitive  Motor  Sensory  Cranial Nerve Function  Cardiovascular assessment  Psychosocial assessment

4. Cognitive Assessment  Intellectual Function -memory -judgment -problem solving/ decision making -speech

5. Motor Assessment  Motor changes -hemiplegia (paralysis) -hemiparesis (weakness) -muscle tone (hyper or hypotonia) -motor activity (agnosia/ apraxia) -bowel/bladder control -gag reflex/ swallowing -self care

6. Sensory Assessment  Sensory changes -sensory loss (touch, pain, heat, cold) -neglect syndrome -spatial/proprioceptive -hemianopsia -Amaurosis fugax

7. Cranial Nerve Assessment  Functional Abnormalities -Assess any difficulties in chewing, swallowing -Assess any facial paralysis

8. Cardiovascular Assessment  Obtain patient history: heart murmur, TIA  Assess vital signs especially BP - history of hypertension

9. Psychosocial Assessment Assess patient’s reaction to illness Assess behavioral changes: -emotional lability -mood changes ( fear, anger, depression) -assess effect on financial status, job

10. Hemorrhagic-Subarachnoid Cerebral Aneurysm  Warning Symptoms: sudden onset of a severe headache – “worst headache of one’s life”  Change of LOC, Neurological deficits, nausea, vomiting, seizures, stiff neck  Prognosis: many patients die or left with significant cognitive difficulties

12. Diagnostic Tests  CAT scan  MRI/ MRA  SPECT (Single-photon emission computed tomography)  Carotid Doppler Studies  Angiography  Lumbar puncture  Glascow Coma Scale: monitor neurological status