Recombinant tissue plasminogen activator (tPA), unless contraindicated monitor for bleeding.Administer anticoagulant agents as prescribed (eg, lowdose aspirin therapy).Prepare and support patient through carotid endarterectomy.Help patients alter risk factors for stroke encourage patient to quit smoking, maintain a healthy weight, follow a healthy diet (including modest alcohol consumption), and exercise daily.Transthoracic or transesophageal echocardiography.History and complete physical and neurologic examination.Depression, other psychological problems: emotional lability, hostility, frustration, resentment, and lack of cooperation.Such dysfunction may be reflected in a limited attention span, difficulties in comprehension, forgetfulness, and lack of motivation. Frontal lobe damage: Learning capacity, memory, or other higher cortical intellectual functions may be impaired.Impaired Cognitive and Psychological Effects Sensory losses: slight impairment of touch or more severe with loss of proprioception difficulty in interrupting visual, tactile, and auditory stimuli.Disturbances in visualspatial relations (perceiving the relation of two or more objects in spatial areas), frequently seen in patients with right hemispheric damage.Visualperceptual dysfunctions (homonymous hemianopia ).Apraxia (inability to perform a previously learned action).Dysphasia (impaired speech) or aphasia (loss of speech).Flaccid paralysis and loss of or decrease in the deep tendon reflexes (initial clinical feature) followed by (after 48 hours) reappearance of deep reflexes and abnormally increased muscle tone (spasticity).General signs and symptoms include numbness or weakness of face, arm, or leg (especially on one side of body) confusion or change in mental status trouble speaking or understanding speech visual disturbances loss of balance, dizziness, difficulty walking or sudden severe headache. Asymptomatic carotid stenosis and valvular heart disease (eg, endocarditis, prosthetic heart valves).The result is an interruption in the blood supply to the brain, causing temporary or permanent loss of movement, thought, memory, speech, or sensation.Cryptogenic strokes have no known cause, and other strokes result from causes such as illicit drug use, coagulopathies, migraine, and spontaneous dissection of the carotid or vertebral arteries. Ischemic strokes are categorized according to their cause: large artery thrombotic strokes (20%), small penetrating artery thrombotic strokes (25%), cardiogenic embolic strokes (20%), cryptogenic strokes (30%), and other (5%).Strokes are usually hemorrhagic (15%) or ischemic/nonhemorrhagic (85%).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |