stroke (cva)

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2. Anatomy 3. Definition Also known as cerebrovascular accident (CVA). A stroke is the sudden death of brain cells in alocalized area due to inadequate blood flow. Sudden onset of neurological sign andsymptoms, usually focal and acute. It involve blood vessels which can causetemporary or permanent loss of function.(World Health Organization, 1989) 4. Risk Factors Hypertension Diabetes Mellitus Heart disease Cigarette or other tobacco use. Cigarettescause the carotid arteries to develop severeatherosclerosis or to close. Atherosclerosis isaccelerated by smoking. Head injury Obesity 5. EtiologyCEREBRAL HEMORRHAGE- Often d/t HPT &combination of weakness ofvessel wall & lead tohemorrhageISCHAEMIA-gradual occlusion of bloodvessel (slow onset ofsymptoms)SUBARACHNOID HEMORRHAGE- d/t berry aneurysm withhemorrhage into subarachnoidtypeCEREBRALEMBOLISMBlock of blood vesselto the brain 6. Types of strokeIschemic Hemorrhagic-Interruption of blood supplydepress oxygen and nutrient tobrain cell and make severitybrain death/ damage dependingon total blood supply lack.- Ischemic embolism- Ischemic thrombotic- lacunar syndrome-d/t burst of blood vessel thatsupply brain- commonly d/t aneurysm & TIA- Intracerebral haemorrhage-Subarachnoid heamorrhage 7. Classification of Stroke 1) Transient Ischemic Attack Acute of focal cerebral or monocular function withsymptoms lasting 24hr 8. 3) Arteriosclerotic dementia- Deterioration in previously normalmemory/intellect d/t repeated episode ofcerebral ischemic infarction or hemorrhage( Ann thompson,1994) 9. Symptoms Sudden numbness or weakness of face, arm or leg, especially onone side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known causeOther important but less common symptoms include: Sudden nausea, and vomiting - different from a viral illness becauseof how fast it begins (minutes or hours vs. several days) Brief loss of consciousness or a period of decreased consciousness(fainting, confusion, convulsions or coma)(National Stroke Association) 10. PATHOPHYSIOLOGYAtheroma cause the narrowing of arteriesCause increase in blood pressureRupture of the vessel.Internal bleeding blood clot or hematomaCause ischemia-necrosisBrain cell damage 11. Drs Investigation CT Scan Computed Tomography Scan MRI-Magnetic Resonance Imaging. MRA-Magnetic Resonance Angiography. Lumbar Puncture-CSF test.Drs Management Medical antibiotics ,IV Methanol . Surgical Craniotomy, Vascular reconstructivesurgery, Clipping of rupture aneurysm.(Tidys physiotherapy,1991) 12. Physiotherapy ManagementAcute CareAims :1)Prevent recurrent stroke2)Monitor vital signs, dysphasia adequate nutrition, bladder &bowel function.3)Prevent complications4)Mobilize the patient5)Encourage resumption of self-care activities6)Provide emotional support & education for patient & family7)Screen for rehabilitation and choice of settings 13. Rehabilitation careAims :1)Set rehabilitation goals; develop rehabilitation plan andmonitor progress2)Manage sensory-motor deficits3)Improve functional mobility & independence4)Prevent & treat complications5)Monitor functional health conditions6)Discharge planning (safe residence recommendation,patient & caregivers education & continuity of care)7)Community reintegration(Physiotherapy Practice Guidelines for Stroke Rehabilitation,May 2000)


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