From the Guidelines
Neurological deficits associated with a cerebrovascular accident (CVA) or stroke can include a range of cognitive, emotional, and physical impairments, with the most commonly affected domains being attention, processing speed, and executive function, as well as memory, language, and visuospatial abilities. These deficits occur due to damage to specific areas of the brain caused by either ischemia (lack of blood flow) or hemorrhage, and can be attributed to vascular pathology with a range of presentations, including cortical or subcortical infarct(s), strategic infarcts, small-vessel disease with white matter lesions, lacunar infarcts, or brain hemorrhage 1. The location and extent of the brain damage determine the specific neurological deficits experienced, with damage to the left hemisphere often affecting language, while right hemisphere damage may impact spatial awareness.
Some of the specific neurological deficits associated with stroke include:
- Weakness or paralysis on one side of the body (hemiparesis or hemiplegia)
- Numbness or sensory loss on one side of the body
- Speech and language problems (aphasia or dysarthria)
- Vision problems (partial or complete loss of vision, double vision)
- Balance and coordination issues (ataxia)
- Difficulty swallowing (dysphagia)
- Cognitive impairments, such as:
- Emotional changes, such as depression, anxiety, and mood swings
Prompt recognition of these symptoms is crucial for early intervention and improved outcomes in stroke patients, and in-depth neuropsychological assessments may be necessary to evaluate the full range of cognitive domains affected by cerebrovascular disease 1.
From the Research
Neurological Deficits Associated with CVA or Stroke
The neurological deficits associated with a cerebrovascular accident (CVA) or stroke can be severe and long-lasting. Some of the key deficits include:
- Motor deficits, such as hemiparesis, which can result in significant disability and dependence 2
- Apraxic deficits, including buccofacial and limb apraxia, which can affect an individual's ability to perform purposeful actions 3, 4
- Cognitive deficits, including executive function, attention, and memory impairments, which can impact upper-limb motor recovery 5
Motor Deficits
Motor deficits, such as progressive hemiparesis, are a common consequence of stroke. These deficits can be caused by lacunar stroke, which is a type of stroke that occurs due to small-vessel disease 2. The severity of motor deficits can vary, but they can have a significant impact on an individual's quality of life.
Apraxic Deficits
Apraxic deficits, including limb apraxia, can also occur after a stroke. These deficits can be caused by lesions in the left hemisphere of the brain and can affect an individual's ability to perform gestures, pantomime, and use objects 3, 4. Apraxic deficits can be challenging to treat, but rehabilitation therapies aimed at restoring perceptuo-semantic deficits or compensating for these deficits can be effective.
Cognitive Deficits
Cognitive deficits, including executive function, attention, and memory impairments, can also impact upper-limb motor recovery after a stroke. Studies have shown that there is a moderate association between cognition and overall arm motor recovery, with executive function and attention being particularly important for motor recovery 5.
Rehabilitation and Recovery
Rehabilitation and recovery from stroke-related deficits can be complex and challenging. However, studies have shown that targeted and personalized therapies can be effective in promoting recovery. For example, therapies aimed at enhancing corticospinal tract axonal remodeling can promote neurological recovery after stroke 6. Additionally, rehabilitation therapies aimed at restoring perceptuo-semantic deficits or compensating for apraxic deficits can also be effective 4.