CVD

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CVD

  1. 1. Cerebral Vascular Disease (CVD) Speaker: 马圣念
  2. 2. What is the CVD? Cerebrovascular disease is a group of brain dysfunctions related to disease of the blood vessels supplying the brain. Hypertension is the most important cause It damages the blood vessel lining, endothelium, exposing the underlying collagen.
  3. 3. Anatomy of Cerebral Vascular 1 -Internal Carotid Artery System -Vertebral Basilar Arterial System -Willis Circulation
  4. 4. Anatomy of Cerebral Vascular 2
  5. 5. Anatomy of Cerebral Vascular 3 The weight of the brain: 2%~3% Blood supply of the brain: 15%~20% There is no reserve energy in brains.
  6. 6. Anatomy of Cerebral Vascular 4
  7. 7. Etiology of CVD • High Blood Pressure • High Blood Cholesterol • High Body Mass Index (BMI)
  8. 8. Risk Factors of CVR Non modifiable Modifiable • Age • Hypertension • Male sex • Diabetes • Race • Smoking • Heredity • Hyperlipidemia • Excess Alcohol • Heart disease (AF) • Hypercoagulability
  9. 9. Epidemiology of CVD
  10. 10. Classification of CVD • Cerebral Infarction, CI (or called Cerebral Ischemic Stroke) • Intracerebral Hemorrhage, ICH • Subarachnoid Hemorrhage • Transient Ischemic Attack, TIA
  11. 11. Cerebral Infarction, CI A Cerebral Infarction is the ischemic kind of stroke due to a disturbance in the blood vessels supplying blood to the brain.
  12. 12. • Middle Cerebral Artery (MCA) • Internal Carotid Artery (ICA)
  13. 13. Infarction Stages 1 Immediate (<24 hours) No Change : gross, micro  Na/K loss, Ca+ influx.
  14. 14. Infarction Stages 2 Acute stage (< 1week) Oedema, loss of grey/white matter border. Inflammation, Red neurons, necrosis, neutrophils
  15. 15. Cerebral Edema Normal Edema
  16. 16. Cerebral Edema
  17. 17. Infarction Stages 3 Late stage (> 1 weeks) Removal of tissue by macrophages Fluid filled cysts with dark grey margin (gliosis)
  18. 18. Principle of Diagnosis • The middle aged people and the elder • Hypertension, Hyperlipidemia, Diabetes, TIA History • Disease onsets in quiet situation • Symptoms gradually worsened • Hemiplegia, Aphasia, etc • CT, MRI test
  19. 19. Principle of Therapy • Early thrombolytic • Adjustment of blood pressure • Prevention of brain edema • Anticoagulant therapy • Vascular dilatation • Brian nutrition therapy • Surgeon therapy • Interventional therapy
  20. 20. Principle of Nursing • Medication Nursing • Prevention of Asphyxia • Mental Nursing • Health Education
  21. 21. Intracerebral Hemorrhage, ICH A Cerebral Hemorrhage (or intracerebral hemorrhage, ICH), is a subtype of intracranial hemorrhage that occurs within the brain tissue itself. Intracerebral hemorrhage can be caused by brain trauma, or it can occur spontaneously in hemorrhagic stroke. Non-traumatic intracerebral hemorrhage is a spontaneous bleeding into the brain tissue.
  22. 22. • Middle Cerebral Artery (MCA) • Lenticulostriate artery
  23. 23. Brain Herniation -Cardiac arrest (no pulse) -Coma -Irregular breathing -Irregular pulse -Loss of all brainstem reflexes (blinking, gagging, pupils reacting to light) -Progressive loss of consciousness -Respiratory arrest (no breathing)
  24. 24. Brain Herniation (abnormal posturing) • Decorticate posturing: with elbows, wrists and fingers flexed, and legs extended and rotated inward • Brain herniation frequently presents with abnormal posturing. a characteristic positioning of the limbs indicative of severe brain damage.
  25. 25. Principle of Diagnosis • Over age-50 who has history of hypertenxion • Accidence in the emotional or physical activtise • Emerging the symptoms of intracranial pressure rising and disturbance of consciousness • CT, MRI test
  26. 26. Principle of Therapy • No movement, O2 • Adjustment of blood pressure • Control of brain edema • Application of hemostatic • Surgeon therapy
  27. 27. Principle of Nursing • Basic Nursing • Prevention of Asphyxia • Complications: Brain Herniation • Complications: Upper Gastrointestinal Bleeding
  28. 28. Subarachnoid Hemorrhage A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space
  29. 29. Principle of Diagnosis • More among the youth, Female>Male • Accidence in the emotional or physical activtise • CSF test • CT, MRI test
  30. 30. UNESCO Training the Trainers in Information Literacy Workshop, September 3-5, Ankara-Turkey 38
  31. 31. Principle of Therapy • No movement, O2 • Adjustment of blood pressure • Application of hemostatic • Surgeon therapy
  32. 32. Principle of Nursing • Basic Nursing • Prevention of Asphyxia • Complications: Brain Herniation • Complications: Upper Gastrointestinal Bleeding
  33. 33. Transient Ischemic Attack, TIA A transient ischemic attack (often colloquially referred to as “mini stroke”) is a change in the blood supply to a particular area of the brain, resulting in brief neurologic dysfunction that persists, by definition, for less than 24 hours.
  34. 34. Three-Theory Etiology
  35. 35. Typical Symptom • Temporary loss of vision • Difficulty speaking (aphasia) • Weakness on one side of the body • Numbness or tingling, usually on one side of the body.
  36. 36. Principle of Diagnosis • Short onset-period • Based on health history • CT, DSA test
  37. 37. Principle of Therapy • Application of hemostatic • Calcium Channel Blockers (CCBs) • Surgeon therapy
  38. 38. Principle of Nursing • Basic Nursing (risk of injury) • Medication Nursing • Appropriate Exercises Recommendation • Complications: Stroke
  39. 39. Thank you for attention 马圣念

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