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STROKE

Presented By:

Nhelia B. Perez RN. MSNNorteastern College –

Nursing Dept.Santiago City, Philippines

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Nakaka stroke

ang dating!

!!!

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Stroke• A stroke is a medical emergency in

which the blood supply to any portion of the brain is interrupted or reduced.

• Alternative names: Cerebrovascular accident/ disease (CVA), Cerebral infarction, Cerebral hemorrhage.

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EpidemiologyStroke is the third leading cause of death in the

United States.

Every year 600,000 people will suffer a new or recurrent stroke, and of those, 160,000 will die.

In the Philippines alone, there are about 500 cases of stroke for every 100,000 individuals every year. It is also estimated that about 400,000 Filipinos have lived through a first stroke with the fear of suffering a second attack, which could finally end their lives.

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The symptoms of a stroke are dependant on what portion of the brain is damage.

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SYMPTOMS

• Paralysis or weakness in the face, arms and/or legs.

• Confusion.

• Personality changes.

• Sudden change in eyesight.

• Decreased motor skills.

• Severe headaches

A sudden development of one or more of the following symptoms usually indicates a stroke.

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Types of stroke:

http://www.memorialhermann.org/library/healthguide/en-us/images/media/medical/hw/h5551195.jpg

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Tests• Computed Tomography (CT)• Magnetic Resonance Imaging (MRI)• Cerebral Angiography: identify responsible

blood vessel• Electrocardiogram (ECG): underlying heart

conditions• Echocardiogram: blood clot from heart• Carotid Duplex: carotid artery stenosis• Heart monitors, blood work and many more

tests!!

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Ischemic Stroke:• A blood vessel

becomes blocked and the blood supply to that part of your brain is blocked.

• Types of Ischemic strokes:– Thrombotic Stroke– Embolic Stroke

http://www.strokeassociation.org/presenter.jhtml?identifier=1014

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Treatments• Tissue plasminogen activator (tPA) can be

given within three hours from the onset of symptoms.

In addition to being used to treat strokes, the following can also be used as preventative measures.– Anticoagulants/Antiplatelets– Carotid Endarterectomy– Angioplasty/Stents

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Ischemic Stroke

http://www.ucihs.uci.edu/stroke/images/tumor.png

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CT MRI

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Hemorrhagic Stroke:

• A small blood vessel in the brain becomes weak and ruptures.

• Types of hemorrhagic stroke:– Intracerebral hemorrhage

(ICH)– Subarachnoid

hemorrhage

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Treatment• Surgery is often required to remove

pooled blood from the brain and to repair damaged blood vessels.

Prevention:• An obstruction is introduced to prevent

rupture and bleeding of aneurysms and arteriovenous malformations (AVM).– Surgical Intervention– Endovascular Procedures

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Hemorrhagic Stroke

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Transient Ischemic Attack (TIA)

• Blood supply to the brain is only briefly interrupted

• Symptoms do not last long

• Warning Stroke- steps should be taken to prevent future stroke.

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RISKS• TIA• CAD• High Blood Pressure• High Cholesterol• Smoking• Heart Disease• Diabetes

• Excessive alcohol consumption

• Family History• Age• Sex• Race• Obesity

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Prevention• Control high Blood Pressure• Lower cholesterol• Quit smoking• Control diabetes• Maintain healthy weight• Exercise• Manage stress• Eat a healthy diet

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Prognosis• The results of a stroke vary depending

on the size and location, the presence of any associated medical problems, and the likelihood of recurring strokes.

• Dysfunctions correspond to the area in the brain that had been damaged.

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Nursing Management

During the Acute phase, maintain a patent airway and oxygenation.

Watch out for ballooning of the cheek on the affected side with respiration.

If the patient is unconscious, position him on his side to allow secretions to drain and prevent aspiration. If necessary suction the secretions.

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Maintain fluid and electrolyte balance. Offer the urinal or bedpan every 2 hours. Ensure adequate nutrition.Manage GI problems. Provide careful mouth care.Provide meticulous eye care.Position the patient and align his

extremities correctly. Assist the patient with exercise.

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Give medications as ordered and watch for and report adverse reactions.

Establish and maintain communication with the patient.

Provide psychological support.

Protect from injury.