stroke.pptx
- 2. STROKE AND ITS TYPES DR AHMED JAMIL
- 3. DEFINITION • A stroke is defined as the clinical syndrome of rapid onset of cerebral deficit lasting more than 24 hours or leading to death with no apparent cause other than a vascular one. • A stroke is a rapid loss of brain function due to the disturbance in the blood supply to brain. A stroke happens when blood flow to a part of the brain stops and it is sometimes called a "brain attack"
- 5. TYPES • There are three main kinds of stroke: • ▸ Ischemic strokes • ▸ Hemorrhagic strokes • ▸ Transient ischemic attacks (TIAs), also referred to as mini-strokes
- 6. ISCHEMIC STROKE • Ischemic stroke is the most common form of stroke, accounting for around 85% of strokes. • This type of stroke is caused by blockages or narrowing of the arteries that provide blood to the brain, resulting in ischemia - severely reduced blood flow. • These blockages are often caused by blood clots. Clots can be caused by fatty deposits within the arteries called plaque.
- 7. HEMORRHAGIC STROKE • Hemorrhagic stroke are caused by arteries in the brain either leaking blood or bursting open. • The ruptures can be caused by conditions such as hypertension, trauma, blood-thinning medications and aneurysms (weaknesses in blood vessel walls).
- 8. • Intra cerebral hemorrhage is the most common type of hemorrhagic stroke and occurs when brain tissue is flooded with blood after an artery in the brain bursts. • Subarachnoid hemorrhage is the second type of hemorrhagic stroke and is less common. In this type of stroke, bleeding occurs in the subarachnoid space - the area between the brain and the thin tissues that cover it.
- 9. TRANSCIENT ISCHEMIC ATTACK (TIA) • TIAS are different from the aforementioned kinds of stroke because the flow of blood to the brain is only briefly interrupted. • TIAS are similar to ischemic strokes in that they are often caused by blood clots or other debris. • TIAS should be regarded as medical emergencies.
- 11. SYMPTOMS • Strokes occur quickly and, as such, symptoms of stroke often appear suddenly without warning. • The main symptoms of stroke are as follows: • Confusion, including trouble with speaking and understanding • Headache, possibly with altered consciousness or vomiting
- 12. • Numbness of the face, arm or leg, particularly on one side of the body • Trouble with seeing, in one or both eyes • Trouble with walking, including dizziness and lack of co-rdination.
- 13. In addition to the persistence of the problems listed previously, patients may also experience the following: • Bladder or bowel control problems • Depression • Pain in the hands and feet that gets worse with movement and temperature changes • Paralysis or weakness on one or both sides of the body • Trouble controlling or expressing emotions.
- 14. CEREBRAL ARTERY SYNDROMES • Anterior cerebral artery occlusion : • Contralateral hemiparesis and hemisensory loss involving leg and foot • Inability to identify objects correctly and personality changes
- 15. • Middle cerebral artery occlusion : • Contralateral hemiparesis and hemisensory loss involving mainly face and arm • Aphasia if left hemisphere is affected • Contralateral homonymous hemianopia • Anosognosia if right hemisphere is affected
- 16. • Posterior Cerebral artery occlusion : • Contralateral homonymous hemianopia with some degree of macular sparing • Visual agnosia • Impairment of memory
- 17. DIAGNOSIS • There are several different types of diagnostic tests that doctors can use in order to determine which type of stroke has occurred: • CT scans of the brain are one of few ways to determine which type of stroke a person has had. • Physical examination: a doctor will ask about the patient's symptoms and medical history. They may check blood pressure, listen to the carotid arteries in the neck and examine the blood vessels at the back of the eyes, all to check for indications of clotting
- 18. • Blood tests: a doctor may perform blood tests in order to find out how quickly the patient's blood clots, the levels of particular substances (including clotting factors) in the blood, and whether or not the patient has an infection‣ • CT scan: a series of X-rays that can show hemorrhages, strokes, tumors and other conditions within the brain • MRI scan: radio waves and magnets create an image of the brain to detect damaged brain tissue
- 19. • Carotid ultrasound: an ultrasound scan to check the blood flow of the carotid arteries and to see if there is any plaque present • Cerebral angiogram: dyes are injected into the brain's blood vessels to make them visible under X-ray, in order to give a detailed view of the brain and neck arteries • Echocardiogram: a detailed image of the heart is created to check for any sources of clots that could have traveled to the brain to cause a stroke.
- 20. TREATMENT OF STROKE • ISCHEMIC STROKES • ▸ Aspirin can be given, as can an injection of a tissue plasminogen activator (TPA). • ▸ A carotid endarterectomy • ▸ Angioplasty
- 21. • HEMMORHAGIC STROKE • ▸ Treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels. • If the patient is taking anti-coagulant or anti-platelet medication like Warfarin or Clopidogrel, they can be given drugs or blood transfusions to counter the medication’s effects
- 22. • ▸ Surgery can be used to repair any problems with blood vessels that have led or could lead to hemorrhagic strokes. Surgeons can place small clamps at the base of aneurysms or fill them with detachable coils to stop blood flow to them and prevent rupture. • ▸ Surgery can also be used to remove small arteriovenous malformations (AVMS) if they are not too big and not too deep within the brain. AVMs are tangled connections between arteries and veins that are weaker and burst more easily than other normal blood vessels
- 23. REHABILITATION • ▸ Strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke, successful recovery will often involve specific rehabilitative activities such as: • ▸ Speech therapy to help with problems producing or - understanding speech. Practice, relaxation and changing communication style, using gestures or different tones for example, all help • ▸ Physical therapy - to help a person relearn movement and co- ordination. It is important to get out and about, even if it is difficult
- 24. • Occupational therapy to help a person to improve - their ability to carry out routine daily activities, such as bathing, cooking, dressing, eating, reading and writing • Joining a support group to help with common - mental health problems such as depression that can occur after a stroke. Many find it useful to share common experiences and exchange information • Support from friends and family - to provide practical support and comfort. Letting friends and family know what can be done to help is very important.
- 25. PREVENTION • The best way to prevent a stroke is to address the underlying causes. • This is best done by living healthily, which means: • Eating a healthy diet • Maintaining a healthy weight • Exercise regularl • Not smoking • Avoiding alcohol or moderating consumption.