Occlusion of cerebral artery production of ATP failure of energy Results in Clinical features
Aetiology pumps influx of sodium and calcium ions and efflux of potassium Right-sided hemiplegia and
Depletion of blood flow in a causes passive inflow of water cytotoxic oedema destruction of cells in weakness
cerebral artery resulting from Sensory loss on right side
infarct core.
a thrombus or embolus. (1)
Inability to see the right visual field
Membrane depolarisation release of glutamate excessive calcium of each eye
influx into neurons destruction of cells by lipolysis, proteolysis
Aphasia
and free radicals. Apraxia
infarct core and ischaemic penumbra
Dysarthria Diagnosed
necrotic tissue not able to conduct impulses interrupting normal Impaired reasoning by
Atherosclerosis function such as motor and sensory transmission and speech. Behavioural changes
Problems with memory
1,2,3 1,2,4
Prevents formation of
Diagnosis
Risk factors Complete history
Obesity Physical and neurological examination
Smoking Death of brain tissue resulting from an occluded Brain MRI or CT scan –differentiate
Sedentary lifestyle cerebral haemorrhage from ischaemic
Age 1.
cerebral artery in the left side of the brain.. 6.
stroke
ageg
diagnoses Other tests for vascular imaging – CT
angiography, magnetic resonance
Course of disease angiography
With reperfusion – blood
5Leads to need
Primary prevention restored to area, many
for
Don’t smoke symptoms gradually resolve
Without treatment – immediate
influences
Diet high in fruit and vegetables ischaemia extends to Secondary prevention
Diet low in fats and salt penumbra –symptoms worsen. Neuroprotection – e.g, aspirin
Medical
30 minutes of exercise daily Recovery may continue 6 Reperfusion Thrombolytic (tPA )
Limit alcohol months to a year but left with
1,7 disability. Requires
rehabilitation to optimise
6,7
function 8 Rehabilitation Nursing acute phase
Treatment
Passive and active movement Frequent evaluation of neurological status
Encourage activities provided and vital signs
by physiotherapists, speech Oxygen saturations – administer oxygen if
Prognosis and occupational therapists required
One in five likely to die within one month. Complications
e.g. mobility, speech, ADL Screen for swallowing – manage hydration
Of those who recover about 90% will experience Contractures and nutrition
some impairment. 9 Incontinence Education-
Manage activities of daily living
Falls Address appropriate communication
Mood disturbances
strategies
Dysarthria and aphasia Prevent complications