Stroke: Definition, type, Cause, symptoms,sign,complication,treatment Stroke: Definition, type, Cause, symptoms,sign,complication,treatment Doctors media

Ticker

6/recent/ticker-posts

Stroke: Definition, type, Cause, symptoms,sign,complication,treatment

 
Stroke: Definition, type, Cause, symptoms,sign,complication,treatment

Overview of stroke management 

A stroke happens within the second but effects for years. It is a common medical emergency. Stroke is one of the major causes of mortality &morbidity in the elder age group.  The incidence rises steeply with age, and in many lower- and middle-income countries

It is rising in association with less healthy lifestyles. About 20%of stroke patients die within a month of the event and at least half of those who survive are left with a physical disability.

Stroke Definition: what is a stroke?

In medical terms, stroke meaning is a focal neurological deficit due to nontraumatic vascular origin, characterized by unilateral hemiparesis or hemiplegia. It means weakness of any side of the body may be right hand or right leg weakness or maybe left side weakness associated with slurring of speech. Convulsion or seizure or unconsciousness are uncommon. 

Stroke symptoms

A stroke occurs within a second so it occurs very suddenly. The most common presenting feature is the weakness of one side of the body with slurring of speech, facial asymmetry.

Common presentations are:

the weakness of hand and leg  (right/ left )

slurring of speech 

facial weakness or deviation to one side

abnormal walking pattern 

headache 

vertigo

coma 

Signs of a stroke

Signs are objective phenomena 
The important sign of the stroke is the planter extension.
which indicates upper motor neuron lesion sign (lesions origin in the centre)

Type of stroke 

In the relation of time, origin, and fate stroke is several types.
TIA (transient ischemic attack) 
Stroke 
  1. ischemic stroke 
  2. hemorrhagic stroke
  3. progressive stroke 
  4. nonprogressive stroke 

In ischemic stroke,  cell death occurs due to an artery blocked by any plague, thrombus in the lumen.  It is a more common type. about 85% of stroke.Usually less severe than hemorrhagic stroke. May be severe when involved in the central portion and massive form. the patient usually presents with weakness and slurring speech.

hemorrhagic stroke occurs due to the rupture of arteries. Congenital arteriovenous malformation, aneurism of arteries are ruptured. patient presents with severe headache, vertigo, vomiting. unsteadiness, unilateral weakness, unconscious, convulsion, or seizure. In a young person, Hypertension, the stress may be correlated with stroke. 

TIA or transient ischemic attack is also known as a mini-stroke. In which feature of stroke resolves within 24 hours.

what causes a stroke
two basic mechanisms usually cause stroke 

atheromatous plague 

Rupture of intracerebral arteries 

Risk factors are more important to treat and prevention of stroke 

Non modifiable risk factors

• Age
• Gender (male > female except at extremes of age)
• Race (Afro-Caribbean > Asian > European)
• Previous vascular event:

  • Myocardial infarction
  • Stroke
  • Peripheral vascular disease
• Heredity
• Sickle cell disease
• High fibrinogen

Modifiable risk factors

• Blood pressure
• Cigarette smoking
• Hyperlipidaemia
• Diabetes mellitus
• Heart disease:
  • Atrial fibrillation
  • Congestive cardiac failure
  • Infective endocarditis
• Excessive alcohol intake
• Oestrogen-containing drugs:
Oral contraceptive pill
Hormone replacement
therapy
• Polycythaemia


Complications 

Epileptic seizures 

Depression and

anxiety

Painful shoulder

Chest infection

Constipation

Urinary infection 

Pressure sores 

Deep vein thrombosis/pulmonary embolism

stroke treatment: 

supportive care

Airway: Perform bedside screen and keep patient nil by mouth if swallowing unsafe or aspiration occurs.
 
Breathing: Check respiratory rate and give oxygen if saturation < 95%.
 
Circulation: Check peripheral perfusion, pulse, and blood pressure, and treat abnormalities with fluid replacement,  drugs as appropriate Hydration.If signs of fluid loss, give fluids parenterally or by nasogastric tube.
 
Nutrition: Assess nutritional status and provide supplements if needed. If the difficulty of swallowing   persists for >48 hrs, start feeding via nasogastric tube.
 
Medication: If the difficulty of swallowing persists, consider other routes for essential medications.
 
Blood pressure:  Unless there is the heart or renal failure, evidence of hypertensive encephalopathy or aortic dissection, do not lower blood pressure abruptly in the first week as it may reduce cerebral perfusion. Blood pressure often returns towards the patient’s normal level within days.

Blood glucose:  Should Check blood glucose and treat when levels are ≥11.1 mmol/L
(200 mg/dL). Monitor closely to avoid hypoglycemia.

Temperature: If fever, investigate and treat the underlying cause Control with paracetamol, as raised brain temperature may increase infarct volume.

Pressure areas: Reduce the risk of skin breakdown.
 
Treat infection by broad spectram antibiotics.
 
Maintain nutrition: Provide pressure-relieving mattress, Turn immobile patients regularly

Incontinence: Check for constipation and urinary retention; treat  ese appropriately. Avoid urinary catheterization unless the patient is in acute urinary retention or incontinence is reatening pressure areas
 
Mobilization: Avoid bed rest

how to prevent a stroke

prevention of stroke mainly focused on avoidable risk factors.
A lifestyle can prevent any vascular events like stroke, heart attack, etc. The most important is-

Blood pressure control. Uncontrolled hypertension is more prone to developing a stroke. 
 Diabetes control everybody should give strict attention to control Diabetes

 Quite Cigarette smoking as soon as possible.

  Periodically check lipid profile, take a fat-free diet and medicine to reduce it.

 Heart disease: Regular follow up and control the conditions

Atrial fibrillation

Congestive cardiac failure

Infective endocarditis

alcohol intake must be reduced 
Oestrogen-containing drugs:
Oral contraceptive pill Hormone replacement therapy-adjust it accordingly doctors advice.

Stroke recovery
Usually first 24-48 hours are more critical for a stroke patient. The death rate is very high with nhemorrhagic stroke. but longtime disability can hamper person quality of life.

Post a Comment

0 Comments