STROKE

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STROKE
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Stroke

• Classification
• Risk Factors
• Signs and Symptoms
• Management
• Prehospital
• In-hospital

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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

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Classification of Stroke

• Hemorrhagic Stroke
• Subarachnoid
• Aneurysm (most common)
• Arteriovenous malformation
• Intracerebral
• Hypertension (most common)
• Amyloid angiopathy in elderly

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Stroke Risk Factors

• Modifiable
• Hypertension
• Tobacco use
• Hx of TIAs
• Heart Disease
• Diabetes Mellitus
• Hypercoagulopathy
• Pregnancy, cancer, etc.
• Sickle Cell and increased RBC
• Hx of carotid Bruit

• Unmodifiable
• Age
• Gender
• Race
• Previous CVA
• Heredity

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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)

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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

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Netter Atlas of Human Anatomy
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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

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Stroke Signs and Symptoms

• Differential Diagnosis of Stroke
• Head/Cervical trauma
• Meningitis/encephalitis
• Hypertensive encephalopathy
• Intracranial mass
• Tumor
• Sub/epi dural hematoma
• Todds paralysis
• Migraine w/ neuro sx
• Metabolic
• Hyper/hypo glycemia
• Post arrest ischemia
• Drug OD