Transcript 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 – Posterior Circulation • Vertebro-basilar artery distribution involve brainstem or cerebellum Classification of Stroke • Hemorrhagic Stroke – Subarachnoid • Aneurysm (most common) • Arteriovenous malformation – Intracerebral • Hypertension (most common) • Amyloid angiopathy in elderly Stroke – Risk Factors • 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 – 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) 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 Netter; Atlas of Human Anatomy 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 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