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STROKE

STROKE. Stroke. Classification Risk Factors Signs and Symptoms Management Prehospital In-hospital. Classification of Stroke . Ischemic Stroke (75% “Brain Infarct”) Occlusive: Thrombosis Embolism Anterior Circulation Occlusion of carotid artery involve cerebral hemispheres

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STROKE

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  1. STROKE

  2. Stroke • Classification • Risk Factors • Signs and Symptoms • Management • Prehospital • In-hospital

  3. Classification of Stroke • Ischemic Stroke (75% “Brain Infarct”) • Occlusive: • Thrombosis • Embolism • Anterior Circulation • Occlusion of carotid artery involve cerebral hemispheres • Posterior Circulation • Vertebro-basilar artery distribution involve brainstem or cerebellum

  4. Classification of Stroke • Hemorrhagic Stroke • Subarachnoid • Aneurysm (most common) • Arteriovenous malformation • Intracerebral • Hypertension (most common) • Amyloid angiopathy in elderly

  5. Modifiable Hypertension Tobacco use Hx of TIA’s Heart Disease Diabetes Mellitus Hypercoagulopathy Pregnancy, cancer, etc. Sickle Cell and increased RBC Hx of carotid Bruit Unmodifiable Age Gender Race Previous CVA Heredity Stroke – Risk Factors

  6. Stroke – Signs and Symptoms • Ischemic • Carotid Circulation • Unilateral paralysis (opposite side) • Numbness (opposite side) • Language disturbance • Aphasia – difficult comprehension, nonsense, difficult reading/writing • Dysarthria – slurred speech, abnormal pronunciation. • Visual disturbance (opposite side) • Monocular blindness (same side)

  7. Stroke – Signs and Symptoms • Ischemic • Vertebrobasilar Circulation • Vertigo • Visual disturbance • Both eyes simultaneously • Diplopia • Ocular palsy – inability to move to one side • Dysconjugate gaze – asynchronous movement • Paralysis • Numbness • Dysarthria • Ataxia

  8. Netter; Atlas of Human Anatomy

  9. Stroke – Signs and Symptoms • Hemorrhagic • Subarachnoid hemorrhage • Sudden severe HA • Transient LOC • Nausea/Vomiting • Neck pain • Intolerance of noise/light • AMS • Intracerebral hemorrhage • Focal sx w/ LOC, N/V

  10. Stroke – Signs and Symptoms • Differential Diagnosis of Stroke • Head/Cervical trauma • Meningitis/encephalitis • Hypertensive encephalopathy • Intracranial mass • Tumor • Sub/epi dural hematoma • Todd’s paralysis • Migraine w/ neuro sx • Metabolic • Hyper/hypo glycemia • Post arrest ischemia • Drug OD

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