Management of patients with cerebrovascular stroke (CVA)

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Management of patients with cerebrovascular stroke (CVA) by Mind Map: Management of patients with cerebrovascular stroke (CVA)

1. Transient ischemic attack (TIA)

1.1. A transient ischemic attack (TIA) is a temporary neurologic deficit that completely resolves in 24 hours (most last less than 1 hour).

1.2. Manifestation of TIA

1.3. Cause of TIA

2. Assessment and diagnostic findings

2.1. Focused physical and neurologic examination

2.2. Initial assessment

2.3. Noncontrast computed tomography (CT) scan.

2.4. CT angiography

2.5. CT perfusion to identify the source

2.6. Magnetic resonance imaging (MRI)

2.7. Magnetic resonance angiography

2.8. Transcranial Doppler flow studies

2.9. 12-lead ECG & carotid ultrasound

3. Prevention

3.1. Healthy lifestyle

3.1.1. (no smoking, physical activity, healthy weight, and following a healthy diet).

3.2. Specific diets

3.2.1. for those who are at risk

3.2.1.1. Dietary Approaches to Stop Hypertension (DASH) diet

3.2.1.2. Mediterranean diet

3.2.1.3. Overall diets that are rich in fruits and vegetables

3.3. Low-dose aspirin

3.3.1. for those who are at risk

4. Prevention of hemorrhagic stroke:

4.1. Control of hypertension

4.2. Stroke risk screenings for identifying individuals or groups at high risk

4.3. Educating patients and the community about recognition and prevention.

5. Cerebrovascular Disorders

5.1. Ischemic

5.1.1. approximately 87%

5.1.1.1. Types of ischemic strokes

5.1.1.1.1. .large artery thrombotic strokes (20%)

5.1.1.1.2. Small penetrating artery thrombotic strokes (25%)

5.1.1.1.3. .Cardiogenic embolic strokes (20%)

5.1.1.1.4. Cryptogenic strokes (30%)

5.1.1.1.5. Others (5%)

5.2. Hemorrhagic

5.2.1. approximately 13%

5.2.1.1. Intracerebral hemorrhage (10%)

5.2.1.1.1. - Bleeding directly into the brain tissue - It results from a spontaneous rupture of small vessels, that caused by uncontrolled hypertension.

5.2.1.2. Subarachnoid hemorrhage (3%)

5.2.1.2.1. Bleeding fills the cerebrospinal fluid spaces around the brain

5.2.1.2.2. It results from

6. Risk factors

6.1. Non-modifiable risk factors

6.1.1. Age

6.1.2. Gender

6.1.3. Heredity and race

6.1.4. Prior stroke or heart attack

6.2. Modifiable risk factors

6.2.1. Carotid stenosis

6.2.2. Atrial fibrillation

6.2.3. Sedentary lifestyle

6.2.4. Sleep apnea

6.2.5. Smoking

6.2.6. Diabetes mellitus

6.2.7. Dyslipidemia

6.2.8. Excessive alcohol consumption

6.2.9. ercoagulable states

6.2.10. Hypertension

6.2.11. Migraine

6.2.12. Obesity

7. linical Manifestations

7.1. Wide variety of neurologic deficits

7.1.1. Sudden severe headache

7.1.2. Confusion or change in mental status

7.1.3. Dizziness, or loss of balance or coordination

7.1.4. Neurological deficit

7.2. Neurological deficit

7.2.1. Motor Loss

7.2.1.1. A disturbance of voluntary motor control on one side of the body may reflect damage to the upper motor neurons on the opposite side of the brain.

7.2.1.1.1. Hemiplegia

7.2.2. ommunication Loss

7.2.2.1. Aphasia

7.2.2.2. Dysphasia

7.2.2.3. Dysarthria

7.2.3. Perceptual Disturbances

7.2.3.1. Homonymous Hemianopsia

7.2.3.1.1. (blindness in half of field in one or both eyes). • The affected side of vision corresponds to the paralyzed side of the body

7.2.4. Sensory Loss

7.2.4.1. Slight impairment of touch

7.2.4.2. Loss of proprioception

7.2.4.3. Agnosia

7.2.5. gnitive Impairment and Psychological Effects

7.2.5.1. mage has occurred to the frontal lobe, learning capacity, memory, or other higher cortical intellectual functions may be impaired.

7.2.5.1.1. limited attention span

7.2.5.1.2. Difficulties in comprehension

7.2.5.1.3. Forgetfulness

7.2.5.1.4. Lack of motivation

7.2.5.1.5. Depression

7.2.5.1.6. Hostility, frustration, lack of cooperation, and other psychological problems may occur

8. Complications of CVS:

8.1. Aspiration pneumonia.

8.2. Urinary tract infections.

8.3. Cardiac arrhythmias.

8.4. Hyperglycemia.

8.5. Complications of immobility

8.5.1. Musculoskeletal problems

8.5.2. Bowel and bladder dysfunction

8.5.3. Inability to perform self -care

8.5.4. Skin breakdown

9. Medical Management

9.1. A. Thrombolytic Therapy

9.2. B. Endovascular Therapy