Pages Below:
Extradural Haemorrhage
Intracerebral Haemorrhage
Subarachnoid Haemorrhage
Subdural Haemorrhage
| |
Stroke
cerebrovascular accident
- sudden neurological deficit of vascular origin lasting longer than 24
hours
Presentation
- weakness
- collapse
- visual disturbance
- dizziness
- speech problems
- sensory upset
- headache
History
- sudden onset
- static or resolving
- Previous
- Right or Left-handed
Risk Factors
- hypertension
- reducing does reduce risk of infarction and haemorrhage
- smoking
- inactive lifestyle
- raised haematocrit
- statin therapy
- Diabetes
Mellitus
- Hyperlipidaemia
PMHx
FHx
- increased vascular disease in members
DHx
- Anti-hypertensives
- Aspirin
- Warfarin
Review of systems
- weight loss
- constipation
- bladder symptoms
- shoulder subluxation
- pneumonia
SHx
- home
- house type
- ground floor
- modification
- stair lift
- bath seat
- downstairs commode
- dependants
- Carers
- relatives
- friends
- home helps
- allowances
- mobility
Examination
General
CVS
CNS
Limbs
Causes
- haemorrhage (15%)
- subarachnoid 5%
- intracerebral 10%
- infarction (85%)
Areas
- carotid
- vertebrobasilar
- ipsilateral cranial nerve lesions
- contralateral hemiparesis
- cerbrellar / brainstem strokes
Investigations
- FBC
- ESR
- Glucose
- CXR
- Cholesterol
- CT brain
- Carotid Doppler ultrasound
- Echocardiogram if mumur
Treatment
- Acute
- keep hydrated
- good nursing care
- do NOT treat initial hypertension
- In-patient
- screen for risk factors
- nutrition
- aspirin
- physiotherapy
- ocupational therapy
|