which is a result of thrombosis or narrowing of the blood vessel is the mostcommon cause of stroke, accounting for 61% of strokes. Two thirds of thrombotic strokes areassociated with hypertension or diabetes mellitus, both of which accelerate atherosclerosis.Ischemic stroke symptoms may progress in the first 72 hours as infarction and cerebral edemaincrease.
occurs when an embolus lodges in and occludes a cerebral artery, resulting ininfarction and edema of the area supplied by the involved vessel. Embolism is the second mostcommon cause of stroke. Plaque breaks off from the endocardium and enters the circulation. Theembolus travels upward to the cerebral circulation and lodges where a vessel narrows or bifurcates.
A stroke can have an effect on many body functions such as:
motor deficits are the most obvious effect of stroke. Motor defecits includeimpairment of mobility, respiratory function, swallowing, and speech, gag reflex, self careabilities. Symptoms are caused by the destruction of motor neurons in the pyramidal pathway.The characteristic motor deficits include loss of skilled voluntary movement (akinesia),impairment of integration of movements, alterations in muscle tone, and alterations in reflexes.
the left hemisphere is dominant for language skills in right handed persons andin most left handed persons. The client may experience
(an abnormal neurologicalcondition in which language function is disordered or absent because of an injury to certain areasof the cerebral cortex) when a stroke damages the dominant hemisphere of the brain.
clients may have difficulty controlling their emotions. Emotions responses may beexaggerated or unpredictable. Depression and feelings associated with changes in body imageand loss of function can make this worse.
both memory and judgement may be impaired as a result of stroke. A left brain stroke is more likely to result in memory problems related to language. Clients with left brain stroke are often very cautious in making judgments. The client with a right brain stroketends to be impulsive and to move quickly. An example of behaviour with right brain stroke isthe client who tries to rise quickly from the wheelchair without locking the wheels or raising thefoot rests. The client with a left brain stroke would move slowly and cautiously from thewheelchair.
when a stroke affects a hemisphere of the brain, the prognosis for normal bladder function is excellent. Partial sensation of the bladder filling remains and voluntary urination is present. Initially the client may experience frequency, urgency and incontinence. Clients are