General Factors Of Strokes - Lecture Notes

STROKE Risk Factors: 'age doubles atter 56 gender ethnicity Irace Family history Monifiable Risk Factors: hypertension heart disease diaberes smoking obebity previous ΓΙΑ sleep apnea metabolic syndrome poor diet lack of exercise TYPES OF STROKE 1. Ischemic warning signs TIA a. thrombotic injury to vessel wall; clos forms narrowing of lumen our clot bloскаде b. embolic originate in andocandlas later to heart blood clot circulating: lodges in artery 2. Homorr negic buret blood vessel: blood seep into damage brain Hasire 4. intracerebral bulding win the brain (HTN most common cause) subarachnoid in Skull outside brain Habие warning sign: ricadache EMBOLIC STROLE cardiovascular -related rick factors: a-fis, & sjection fraction, infective endocarditis, aneurysm need prophylactic anti-coagulation TRANSIENT ISCHEMIC ATTACKS caused by ischemia (lack of 2) minuks-24hrs no infarction- a warning sign manangement: •look for cose. STROLE control HIN no smoking limit alconol aspirin HEMORRHAGIC STROKE -intracerebral HTN mist common cause symptoms vary subarachnoid Dueding Into CSF space aw arachnoid + pia marer often caused by ang use, trauma,, aneurysm cerebral aneurytm circle of Willis + wlage sllent Killer Sudaen loss of brain funcion due to disruption in blood supply Ischemic thrombus blocks blood flow to part of brain "hemorrhage: bading into brain that results in death of brain cells THROMBOTIC STROKE PREVENTION Procedunts "carotid endarterectomy balloon angloplasty Stenting HEALTH PROMOTION Stroke prevention BE FAST teach now to reduu risk factors STROKE GENERAL DEFICITS motor 1065 opposite side of brain afttected as symptoms homi plegia paralysis on one side 'hemiparesis: weakness communication loas dysarenria diffiwity using muscles to speak dysphasia impaired speech aphasia 100s of speaking ability agrapnia: unable to write alexia: unable to read dysphagla difflowsty swallowing Impaired memory bladder dysfunction I... am... brove B+ Brocas loss of language Bis broke Bubes broken words Bis frustrasco WARNING SIGNS Facc facial droop uneven smile Arms: arm numioness Speechi slurred speech difficulty speaking Time why? what? w wernicke: speech meaningless Wis like, "wnar?" Waocon't undersrand W sells work Balad STROKE LOCATION Eight Hemisphere Language Behavior Hearing may be alert + oriented unaware of doficins euphorik smiles denics Illness joses tonai variation Lett Hemisphert aphabia agraphia Cautious anxiety depressión gult, weakness Singer no deficit DIAGNOSTIC STUDIES MRI non-contrast CT shows size location. distinguión buw ischemic + nemorrhagic EMERGENCY MANAGEMENT monitor airway, breathing circulation remove dentunes. establish IV access call Broke team obrain CT scan imei anticipate thrombolytic therapy for ischemic strok kap NPO monitor us neoro Stanis memory disoriented can't recognite faces no deficit vision visuallspatial deficits neglects loft visual field no discrimination wilettas/words reading proovemb A blindness over field of vision CLINICAL MANIFESTATIONS: HEMIANOPSIA MANAGEMENT -right CVA lett nemiplegia ABCS lett nomianopsia lett CUA: right hemiplegia right hemianopsia time of onset: critical information gire +PA w13-4hrs onset keep BP + •only treat S8P220 or DBP 2120 Improve venous drainage HOB 30° no more) NEUROLOGIC ISSUES Headaches NURSING MANAGEMENT Asian (stress headache) coping mechanism bandlike headache medication education may nare photophobia, phono phobla Taentity triggers lasts minuks doys regular exercise treatment NSAIDs, moscil relaxants Stress migraine (3x) Unilateral throbbing pain, women man risks family nx, age, female, obesty, depression, hormones common food triggers: chocolate, Cheese, oranges, onions, red wine with I without aura Aura occurs before migraine. throbbing, steady, unilateral treatment abortive drugs Cluster effect on trigeminal nerve repeated headaches occur in clusters. • usually occur@night risks: smoking. severe, intense pain, pain around eye (suclling of eye), nasal congestion, pupil constriction Treatment: abortive drugs, 1007 Da #2: Seleure Disorder TYPES: gentrallted both hemispheres replicpay seiture disorder characerited by chronic seizure activity starus epilepticus: rapla sucucosion of epileptic seizures without intervals of consciousness drug diazepam I lorazepam brain damage can occor unf partial or focal-oses one hemisphere unknoion causes genetle facrors auras carilest sign of seizure ictal phase: time blw beg. & end of seleure trauma post-ictal: recovery period tumors Toxicity