SYMPTOMATOLOGY CLINICAL MANIFESTATIONS 1. Dizziness Dizziness is a common occurrence before or after stroke.

It is particularly common with brainstem ACTUAL FINDINGS IMPLICATIONS

stroke. Decreased blood flow in the back of the brain, vertebrobasilar insufficiency the blood vessels leading to the called

brain from the heart may be blocked (known as

atherosclerosis) causes (Swenson, 2008) 2. Speech problems Problems were a with common

which dizziness.

speech early

symptom of a stroke. This was usually due to

weakness of the muscles

that are crucial for speech production on one side of the face. (Health Talk,

2014) 3. Confusion Confusion is a common problem before or after a stroke. When different

areas of the brain are damaged, the pathways

that control thoughts and behaviors can become

jumbled. Stroke confusion is different for everyone, depending on where in the brain place. the It stroke can from takes range difficulty

anywhere

understanding speech to a lack of judgment about serious safety issues.

(Jacques, 2010) 4. Blurred or double vision Visual problems are more common in people who

have

suffered

stroke

affecting the right side of their brain. The damage the stroke does in the brain impacts the visual

pathways of the eye which can result in visual field loss, blurry vision, double vision and moving images. When stroke affects the areas of the brain that processes the information we see, it can cause 'visual neglect' (lack of awareness to one half of the body or space) difficulties as with well as

judging

depth and movement. In a few cases, visual problems caused by stroke can

improve on their own with time. (RNIB, 2012) 5. Sudden severe The other major site of

headache

trouble, the basilar artery, is formed at the base of the skull from the vertebral arteries, which run up

along the spine and join at the back of the head. When stroke or TIAs occur here, both hemispheres of the brain may be affected so that symptoms occur on both sides of the body such as a sudden severe headache. (Simon, 2008) 6. Sudden loss of coordination or problems with balance Loss of coordination on one side of the body. While your limb may be strong, you may not have the coordination something to you do were

before, such as hold a spoon or button a clasp. In rare cases a body part may develop abnormal,

spontaneous movements. (Pressman, 2012) 7. Sudden numbness and weakness Numbness typically occurs on one side of the body, opposite the side of the brain affected by the

stroke. (Caplan, 2007)

ETIOLOGY PREDISPOSING FACTORS CLINICAL MANIFESTATIONS 1. Vices (Alcohol, smoke) Smoking doubles the risk for stroke when compared to a nonsmoker. It reduces the amount of oxygen in the blood, causing the ACTUAL FINDINGS IMPLICATIONS

heart to work harder and allowing blood clots to form more easily. Smoking also increases the amount of build-up in the arteries, which may block the flow

of

blood

to

the

brain,

causing a stroke. Drinking three or more alcoholic beverages a day may raise the risk for spontaneous intracerebral hemorrhage

at a much younger age than typical, researchers found. (National Stroke

Association, 2003) 2. Age For each decade of life after age 55, the chance of having a stroke more than doubles. (American Heart Association, 2006) 3. Diet A poor diet is a major risk factor for a stroke. High-fat foods can lead to the buildup of fatty plaques in your arteries and being

overweight can lead to high blood pressure (NHS Choices, 2012)

4. Sex

Stroke incidence rates are 1.25 times greater in men, but because women tend to live longer than men, more women than men die of stroke each year. ( American Association, 2003) Heart

5. Heredity

The chance of stroke is greater in people who have a family history of stroke. (American Association, 2004) Heart

PRECIPITATING FACTORS CLINICAL MANIFESTATIONS 1. Hypertension The most important ACTUAL FINDINGS IMPLICATIONS

controllable risk factor for stroke (brain attack) is

controlling pressure higher).

high (140/90 High

blood or blood

pressure blood

can vessels

damage (called

arteries) that supply blood to the brain. According to the CDC, reducing the

systolic (or top number) blood pressure by 12 to 13 points can decrease the risk for a stroke by 37%. (John Hopkins Medical

Health Library, 2009) 2. Diabetes Mellitus Diabetes is controllable,

but having it increases the risk for stroke. People with diabetes have 2 to 4 times the risk of having a stroke than someone without

diabetes. Blood pressure for people with diabetes should be 130/80 or less to reduce the risk of stroke. (John Hopkins Medical

Health Library, 2008)

3. Heart diseases

Heart

disease

is

the

second most important risk factor for stroke, and the major cause of death

among survivors of stroke. Heart disease and stroke have many of the same risk factors. (John Hopkins Medical 2008) 4. Cardiac structural abnormalities Damaged heart valves can cause damage, chronic which heart can Health Library,

ultimately increase the risk of developing stroke. This is known as valvular heart disease. New evidence

shows that heart structure abnormalities including

patent foramen ovale and atrial septal defect may possibly increase risk for embolic stroke. (John

Hopkins

Medical

Health

Library, 2012) 5. Atherosclerosis Stroke secondary to

atherosclerosis about 2 out of

affects 1,000

people, or approximately 50% of all those who have strokes. Atherosclerosis (hardening of the arteries) sticky, occurs fatty

when

substances called plaque buildup in the inner lining of the arteries. The plaque may slowly block or narrow an artery or trigger a clot (thrombus). Clots can lead to stroke. (John Hopkins Medical 2008) Health Library,