Catanduanes Forum

JUST WANT TO SHARE YOU THIS INFO. FROM MY COUSIN JAYSON SORREDA, a fresh medicine graduate.

cerbrovascular accident (stroke)- is the rapidly developing loss of
brain functions due to a disturbance in the blood vessels supplying
blood to the brain. This can be due to ischemia (lack of blood
supply) caused by thrombosis or embolism or due to a hemorrhage. As a
result, the affected area of the brain is unable to function, leading
to inability to move one or more limbs on one side of the body,
inability to understand or formulate speech or inability to see one
side of the visual field.

- it is a medical emergency and can cause permanent neurological
damage, complications and death. It is the leading cause of adult
disability in the Philippines and the second most common cause of
death; the first being heart attacks and third being cancer. It is
the number two cause of death worldwide and may soon become the
leading cause of death worldwide.

Risk factors:
1. advanced age
2. hypertension (high blood pressure)
3. Transient ischemic attack (TIA)- is caused by the changes in the
blood supply to a particular area of the brain, resulting in brief
neurologic dysfunction that persists, by definition, for less than 24
hours; if symptoms persist then it is categorized as a stroke
4. diabetes
5. high cholesterol
6. cigarette smoking
7. atrial fibrillation - is a cardiac arrhythmia (abnormal heart
rhythm) that involves the two upper chambers (atria) of the heart.
8. heavy alcohol consumption
9. drug abuse
10. lack of physical activities
11. obesity
12. unhealthy diet

2 types:

1. thrombotic/schemic stroke - In an ischemic stroke, blood supply to
part of the brain is decreased, leading to dysfunction and necrosis
of the brain tissue in that area. There are four reasons why this
might happen: thrombosis (obstruction of a blood vessel by a blood
clot forming locally), embolism (due to an embolus from elsewhere in
the body),systemic hypoperfusion (general decrease in blood supply,
e.g. in shock)and venous thrombosis.Stroke without an obvious
explanation is termed "cryptogenic" (of unknown origin); this
constitutes 30-40% of all ischemic strokes. (This type of stroke
affects papa and tito ed)

2. hemorragic stroke - Intracranial hemorrhage is the accumulation of
blood anywhere within the skull vault. it result in tissue injury by
causing compression of tissue from an expanding hematoma or
hematomas. This can distort and injure tissue. In addition, the
pressure may lead to a loss of blood supply to affected tissue with
resulting infarction, and the blood released by brain hemorrhage
appears to have direct toxic effects on brain tissue and vasculature.

Diagnosis:
1. medical history and physical examination
2. CT scan (without contrast)
3. magnetic resonance imaging (MRI)

treatment: thrombotic
1. thrombolytic agent - drug use to dissolve blood clots (e.g. tissue
plasminogen activator or tPA)
2. anticoagulant - use to prevent colt formation (e.g. heparin)
3. antithrombotic agent - use to prevent clot formation by inhibiting
platelet activation.
4. diuretics - use to prevent cerebral edema by decreasing
intracerebral pressure (e.g. mannitol)
5. citicholine - use to prevent further brain damage
6. piracetam - use to treat aphasia (inability to produce or
comprehend language)

Hemorrhagic stroke
Patients with intracerebral hemorrhage require neurosurgical
evaluation to detect and treat the cause of the bleeding, although
many may not need surgery. Anticoagulants and antithrombotics, key in
treating ischemic stroke, can make bleeding worse and cannot be used
in intracerebral hemorrhage. Patients are monitored and their blood
pressure, blood sugar, and oxygenation are kept at optimum levels.

Stroke rehabilitation - is the process by which patients with
disabling strokes undergo treatment to help them return to normal
life as much as possible by regaining and relearning the skills of
everyday living. It also aims to help the survivor understand and
adapt to difficulties, prevent secondary complications and educate
family members to play a supporting role.

Complications:
1. paralysis
2. bed sores
3. pneumonia
4. incontinence
5. apraxia (inability to performed learned movements)
6.loss of appetite
7.speech loss
8. vission loss
9. pain
10. emotional problems such as anxiety and depressions
11. coma and death

notes: all the complications except bed sores and pneumonia are
depends upon the affected areas of the brain.