الفهرس | Only 14 pages are availabe for public view |
Abstract A stroke is the sudden death of brain cells in a localized area due to inadequate blood flow (Goldstein and Nussbaum, 1998). A stroke occurs when blood flow is interrupted to part of the brain. Without blood to supply oxygen and nutrients and to remove waste products, brain cells quickly begin to die. Depending on the region of the brain affected, a stroke may cause paralysis, speech impairment, loss of memory and reasoning ability, coma, or death. A stroke also is sometimes called a brain attack or a cerebrovascular accident (CVA) (Lapchak and Zhang, 2012). There are four main types of stroke. Cerebral thrombosis and cerebral embolism are caused by blood clots that block an artery supplying the brain, either in the brain itself or in the neck. These account for 70-80% of all strokes. Subarachnoid hemorrhage and intracerebral hemorrhage occur when a blood vessel bursts around or in the brain (Browner et al., 2001). Risk factors for strokes include high blood pressure, diabetes, and heart disease. Cigarette smoking also puts a person at risk for a stroke. Brain tumors are abnormal tissue growths in the skull. They may be secondary tumors caused by the spread of cancer through the body (Thomson, 2009). Apraxia is a disorder of the execution of learned movements which cannot be accounted for by weakness, incoordination, or sensory loss, nor by incomprehension of, or inattention to commands (Can Heugten, 2001). Summary -166- Apraxia is caused by brain damage related to conditions such as head injury, stroke, brain tumor, and Alzheimer’s disease. The damage affects the brain’s ability to correctly signal instructions to the body. Forms of apraxia include the inability to say some words or make gestures (Chin et al., 1998). Various conditions cause apraxia, and it can affect people of all ages. A baby might be born with the condition. A car accident or fall that resulted in head trauma could lead to apraxia (Liepmann et al., 1988). Apraxia is caused by conditions that affect parts of the brain that control movements. Apraxia is a result of damage to the brain’s cerebral hemispheres. These are the two halves of the cerebrum and are the location of brain activities such as voluntary movements (Black et al., 2001). There are several types of apraxia, and a patient could be diagnosed with one or more forms of this condition. The types of apraxia include: Buccofacial or orofacial apraxia is the inability of a person to follow through on commands involving faces and lip motions. These activities include coughing, licking the lips, whistling, and winking. Also known as facial-oral apraxia, it is the most common form of apraxia (National Institute of Neurological Disorders and Stroke, 2009). Limb-kinetic apraxia is the inability to make precise movements with an arm or leg. Summary -167- Ideomotor apraxia is the inability to make the proper movement in response to a command to pantomime an activity like waving. Constructional apraxia is the inability to copy, draw, or build simple figures. Ideational apraxia is the inability to do an activity that involves performing a series of movements in a sequence. A person with this condition could have trouble dressing, eating, or bathing. It is also known as conceptual apraxia. Oculomotor apraxia is characterized by difficulty moving the eyes. Verbal apraxia is a condition involving difficulty coordinating mouth and speech movements. It is referred to as apraxia of speech by organizations including the American Speech Language Hearing Association (ASHA) (Sirven and Malamut, 2008). A person diagnosed with apraxia may also have aphasia, a condition caused by damage to the brain’s speech centers. This results in difficulty reading, witting, speaking, and understanding when others speak (Tanner, 2007). Diagnosis of apraxia could begin with testing of its underlying cause. Testing for conditions like a stroke or cancer includes the MRI (magnetic resonance imaging) and CT scanning (computer tomography scanning). A brain biopsy is used to measure changes caused by Alzheimer’s disease. In all cases, the physician takes a family history. Head trauma that could cause apraxia is first treated in the emergency room (Ropper and Brown, 2005). Summary -168- Other diagnostic treatment is related to identifying the type of apraxia. For example, the physician may ask the patient to demonstrate how to blow out a candle, wave, use a fork, or use a toothbrush (Ropper and Brown, 2005). The treatment for apraxia usually involves rehabilitation through speech-language therapy, physical therapy, or occupational therapy (Bratton, 2010). Speech-language therapy focuses on helping the patients learn or regain communication skills. Therapists teach exercises to strengthen facial muscles used in speech. Other exercises concentrate on patients learning to correctly pronounce sounds and then turn those sounds into words (Johnson and Jacobson, 2007). Occupational and physical therapies focus on helping patients regain the skills impaired by apraxia. Physical therapy exercises concentrate on areas such as mobility and balance. Occupational therapy helps patients relearn daily living skills (Ferguson, 2008). The prognosis for apraxia depends on factors such as what caused the condition. While Alzheimer’s is a degenerative condition, a child with verbal apraxia or a stroke patient could make progress (Coffey et al., 2007). |