Professional Documents
Culture Documents
Accident(CVA)
Cerebrovascular accidents include
Ischemic stroke,
Hemorrhagic stroke,
Embolic stroke
1.Cardioembolic
2.Atherosclerosis
3.Hypercoagulable states
4.Moya Moya disease
5.Binswangers disease
6.CADASIL
7.Arteritis
8.Venous sinus thrombosis
9.Drugs
Risk Factors Cigarette smoking
Hypertension Substance abuse
Diabetes mellitus Atherosclerosis
Obesity
Oral contraceptives Sedentary life-style
Pregnancy Hyperlipidemia
Menopause Atrial fibrillation
Cardiac disease
Sources of emboli:
Embolic CVA
• Atrial fibrillation
• Blood clot or clump of • Carotid
matter lodges in atherosclerotic plaque
cerebral blood vessel
• Bacterial endocarditis
• MI
• Frequently in
bifurcation of vessels
• RHD
• Ventricular aneurysm
Hemorraghic stroke Causes:
• Intracranial • Hypertension
hemorrhage • Intracranial aneurysm
• Cerebral blood vessel • Trauma
rupture • Tumors
• Most fatal • AV malformation
• Anticoagulants
• Blood disorders
Manifestations
Hemiplegia
Hemiparesis
Cranial nerve palsy
Hemianopia
Monoplegia/ paresis
Seizures
Aphasia
Sensory deficit
Cognitive disturbances
Death
Complications
Aspiration
Recurrent infections
Disuse atrophy
Reduced quality of life
Dependent edema
Orthostatic hypotension
Thrombus formation
Osteoporosis
Renal calculi
Contractures
Pressure ulcers
Investigations
CT brain
MRI
Carotid doppler
CT shows
Lft.MCA infarct
Massive
Midline shift present
Rt. Capsular
hemorrhage
No midline shift
Treatment
Acute stroke
1.Golden hour < 3 hrs
2.t- PA for thrombolysis
Anti platelets – aspirin, clopidogrel
Heparin
venous infarct, embolic stroke
Statins
Mass effect
Anti edema measures
mannitol, dexamethasone
Control of hypertension
Anti epileptics for seizure
Physiotherapy
Occupational therapy
Speech therapy
Adequate nursing care