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84: CEREBROVASCULAR ACCIDENT

Mollie Venglar, DSc, MSPT, NCS; Megan Samantha Rosga, DPT, MSPT, NCS

CONDITION/DISORDER SYNONYMS

  • Cerebral vascular accident

  • Stroke

ICD-9-CM CODES1

  • 430 Subarachnoid hemorrhage

  • 431 Intracerebral hemorrhage

  • 432 Other and unspecified intracranial hemorrhage

  • 433 Occlusion and stenosis of precerebral arteries

  • 434 Occlusion of cerebral arteries

  • 434.0 Cerebral thrombosis

  • 434.00 Cerebral thrombosis without cerebral infarction

  • 434.01 Cerebral thrombosis with cerebral infarction

  • 434.1 Cerebral embolism

  • 434.10 Cerebral embolism without cerebral infarction

  • 434.11 Cerebral embolism with cerebral infarction

  • 434.9 Cerebral artery occlusion unspecified

  • 434.90 Cerebral artery occlusion unspecified without cerebral infarction

  • 434.91 Cerebral artery occlusion unspecified with cerebral infarction

  • 435 Transient cerebral ischemia

  • 436 Acute but ill-defined cerebrovascular disease

  • 437 Other and ill-defined cerebrovascular disease

  • 438 Late effects of cerebrovascular disease

ICD-10-CM CODES2

  • I63.30 Cerebral infarction due to thrombosis of unspecified cerebral artery

  • I63.40 Cerebral infarction due to embolism of unspecified cerebral artery

  • I63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery

  • I66.09 Occlusion and stenosis of unspecified middle cerebral artery

  • I66.19 Occlusion and stenosis of unspecified anterior cerebral artery

  • I66.29 Occlusion and stenosis of unspecified posterior cerebral artery

  • I66.9 Occlusion and stenosis of unspecified cerebral artery

PREFERRED PRACTICE PATTERN

5D: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System—acquired in adolescence or adulthood3

FIGURE 84-1

Brain is supplied by anterior cerebral artery (darker gray region anterior-medial), middle cerebral artery (lighter gray region comprising the majority of the cerebral cortex), and posterior cerebral artery (unshaded portion posterior). (Modified with permission from Schwartz DT. Emergency Radiology: Case Studies. New York, NY: McGraw-Hill; 2008:505.)

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PATIENT PRESENTATION

A 59-year-old man with a history of hypertension (HTN) presents to the emergency department (ED) with right-sided paralysis and aphasia. The patient’s wife states he was in his normal state of health until 1 hour ago, when she heard a thud in the bathroom and walked in to find him collapsed on the floor. She immediately called emergency medical services, which transported the patient to the ED. En route, his finger-stick blood sugar was 108 mg/dL. On arrival in the ED, the patient is placed on monitors and an IV is established. His temperature is 36.8°C (98.2°F), blood pressure is 169/93 mm Hg, heart rate 86 beats per minute, and respiratory rate is 20 breaths per minute. The patient has a noticeable left-gaze preference and is verbally unresponsive, although he will follow simple commands such as raising his left thumb. He has a normal neurological examination on the left, but on the right has a facial droop, no motor activity, decreased deep tendon reflexes (DTRs), and no sensation to light-touch.4

KEY FEATURES

Description

  • Results in sudden, specific neurological deficit based on location and ...

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