If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus, the nurse would anticipate that the client has problems with:
A. Body temperature control
B. Balance and equilibrium
C. Visual acuity
D. Thinking and reasoning
Correct Answer: A. Body temperature control
The body’s thermostat is located in the hypothalamus; therefore, injury to that area can cause problems of body temperature control. The spinothalamic tract is the sensory pathway for pain, temperature and crude touch that originates in the spinal cord and feeds into the ventral posterolateral nucleus of the thalamus for further processing, while the ventral posteromedial nucleus receives sensory information from the trigeminal nerve about the face.
Option B: Balance and equilibrium problems are related to cerebellar damage. Cerebellar dysfunction causes balance problems and gait disorders along with difficulties in coordination resulting in ataxia, uncoordinated movements, imbalance, speech problems(dysarthria), visual problems (nystagmus) and vertigo as a part of the vestibulocerebellar system.
Option C: Visual acuity problems would occur following occipital or optic nerve injury. The optic tracts relay sensory information from the contralateral visual fields. For example, the right optic tract relays sensory information from the left visual field. Also, before forming the optic tracts, some nerve fibers from each eye will travel superiorly to synapse in the SCN located within the hypothalamus. This synaptic input influences the circadian rhythm controlled by the SCN.
Option D: Thinking and reasoning problems are the result of injury to the cerebrum. Cerebral cortex dysfunction can occur due to a variety of causes (lesions) like tumors, trauma, infections, autoimmune diseases, cerebrovascular accidents. The clinical features for each cause will depend on which lobe is affected. I will review some of the clinical features and their relation to each lobe.
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