Cerebrovascular

Accident
01
Definition
 About the Disease

There are
Cerebrovascular types of CVA
two main
accident (CVA) , or stroke:
e brain an ischemic
sudden death of som
stroke is cau
blockage; sed by a
oxygen
cells due to lack of a hemorrha
gic stroke is
to the
when the blood flow by the rupture
of a blood ve
caused
brain is impaired by
ssel.
of an Both types o
blockage or rupture f stroke dep
rive part
A CVA is of the brain
artery to the brain. causing brain
of blood and
oxygen,
stroke.
also referred to as a
cells to die.
02
Signs and
Symptoms
 Signs and Symptoms

Difficulty walking Loss of balance

and coordination

difficulty speaking or
dizziness
understanding others
who are speaking
 Signs and Symptoms

a sudden headache,
numbness or paralysis in especially when
the face, leg, or arm, most accompanied by nausea,
likely on just one side of vomiting, or dizziness
the body
blurred or
darkened vision
03
Management
or Treatment
Proper medical evaluation and
prompt treatment are vital to
recovering from a stroke.
“Time lost is brain lost.” Call 911 as
soon as you realize you may be
having a stroke, or if you suspect a
loved one is having a stroke.
— American Heart Association
 Management or Treatment
Emergency Surgical
measures clipping
If you take blood- A surgeon places a tiny
thinning medications to clamp at the base of the
prevent blood clots, you aneurysm, to stop blood
may be given drugs or flow to it. This clamp can
transfusions of blood keep the aneurysm from
products to counteract the bursting, or it can keep an
blood thinners' effects. aneurysm that has recently
hemorrhaged from
bleeding again.
Coiling
(endovascular
embolization)
Using a catheter inserted
into an artery in your
groin and guided to your
brain, your surgeon will
place tiny detachable coils
into the aneurysm to fill it.
 Management or Treatment

Mechanical thrombectomy
During this procedure, the doctor
inserts a catheter into a large blood
vessel inside your head. They then
use a device to pull the clot out of
the vessel. This surgery is most
successful if it’s performed 6 to 24
hours after the stroke begins.
Management or Treatment

Surgery
In the rare instances that other
treatments don’t work, your doctor
may perform surgery to remove a
blood clot and plaques from your
arteries. This may be done with a
catheter, or if the clot is especially
large, your doctor may open an artery
to remove the blockage.
 Management or Treatment

Antiplatelet and Clot-breaking Stents

anticoagulants drugs If your doctor finds where
Over-the-counter aspirin is Thrombolytic drugs can artery walls have
often a first line of defense break up blood clots in weakened, they may
against stroke damage. your brain’s arteries, perform a procedure to
Anticoagulant and which still stop the stroke inflate the narrowed artery
antiplatelet drugs should and reduce damage to the and support the walls of
be taken within 24 to 48 brain. the artery with a stent.
hours after stroke
symptoms begin.
 Recovering from Stroke:
Speech therapy
A stroke can cause speech and
language impairment. A speech and
Relearning sensory skills
language therapist will work with If the part of your brain that relays sensory signals is
you to relearn how to speak. Or, if affected during the stroke, you may find that your
you find verbal communication senses are “dulled” or no longer working. That may
difficult after a stroke, they’ll help mean that you don’t feel things well, such as
you find new ways of temperature, pressure, or pain. A therapist can help
you learn to adjust to this lack of sensation.
communication.

Cognitive therapy Physical therapy

After a stroke, many survivors have Muscle tone and strength may be
changes to their thinking and reasoning weakened by a stroke, and you may
skills. This can cause behavioral and mood find you’re unable to move your
changes. An occupational therapist can body as well as you could before. A
help you work to regain your former physical therapist will work with
patterns of thinking and behavior and to you to regain your strength and
control your emotional responses. balance, and find ways to adjust to
any limitations.
04
Nursing care
procedures
 Nursing care has a significant impact on the patient’s recovery. In
summary, here are some nursing interventions for patients with stroke:

Positioning Prevent edema venous

Prevent a
dduction Prevent
to prevent to stasis
Position relieve Elevate affected arm
Prevent ad is. ful in
contractures, d body duction of preven t ed em a an d fib ros is help tasis,
pressure, a
ttain g oo affected sh the motion. Exercise u s s
re vent oulder wit Full range of g veno
an d p pillow placed h a
ge of preventin p o se the
alignment, hi es. in the axilla. Provide ful l ran
m ay pre d is
and
e neuropat times a wh ich s is
compressiv A pply motion fo ur or fiv e thrombo
flexion. joint patient to mbolus.
Prevent re vent day to maintain ye
ght to p pulmonar
splint at ni d mobility.
the af cte fe
flexion of
extremity.
 Nursing care has a significant impact on the patient’s recovery. In
summary, here are some nursing interventions for patients with stroke:

xion
Prevent fle Full Rang
e of Motio Regain Balance
to n
nt at night e intain
Apply spli n of th Provide fu Teach patient to ma
exio on,
prevent fl ll range
of balance in a sit ting po siti
ct e d ex tr emity. motion four
or five times balan ce wh ile
affe day to a then to
maintain ing and beg in wa lking
mobility. joint stand
balance
as soon as standing
is achieved .
 Nursing care procedures
Personal hygiene
Encourage personal hygiene
activities as soon as the patient
can sit up.
Manage sensory
difficulties
Approach patient with a decreased
field of vision on the side where
visual perception is intact.
Voiding pattern
Analyze voiding pattern and
offer urinal or bedpan on
patient’s voiding schedule
Assess skin
Frequently assess skin for signs of
breakdown, with emphasis on bony
areas and dependent body parts.
05
Laboratories
and its
Significance
 Laboratories and its significance

CT Scan and MRI

Scan
can be used to diagnose ischemic
stroke, hemorrhagic stroke, and other
problems involving the brain, brain
stem, and spinal cord.

Tests that View the Brain, Skull, or Spinal Cord

Laboratories and its significance
Carotid Doppler
Painless ultrasound waves are
used to take a picture of the carotid
arteries in the neck, and to show
the blood flowing to the brain. Cerebral arteriogram
This test can show if the carotid
artery is narrowed by A catheter is inserted in an
arteriosclerosis (cholesterol artery in the arm or leg, and a
deposition). special dye is injected into
the blood vessels leading to
the brain. Transcranial
Doppler
Ultrasound waves are used
Magnetic resonance to measure blood flow in
angiogram some of the arteries in the
brain.
special type of MRI scan which
can be used to see the blood
vessels in the neck or brain.

Tests that View the Blood Vessels that Supply the Brain
 Laboratories and its significance
Echocardiogram Chest x-ray
An x-ray of the heart and lungs
Painless ultrasound waves are used is a standard test for patients
to take a picture of the heart and the with acute medical problems.
circulating blood. The ultrasound Abnormalities may alert the
probe may be placed on the chest or doctor to important problems
deep in the throat. such as pneumonia or heart
failure.

Urinalysis
Pulse oximetry A urine sample is often
Electrocardiogram obtained to screen for
painless test is sometimes bladder infection or
standard test to show the pattern done in the emergency room kidney problems. If
of electrical activity in the heart. or hospital to determine if infection is suggested, a
3-10 electrical leads are attached your blood is receiving urine culture test may be
enough oxygen from the required.
to the chest, arms and legs.
lungs. A small probe with a
red light is usually attached
to one finger.

Tests that View the Heart or Check its Function Routine Screening Tests
Thank you.