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By….. Dr Guruprasad shetty. Padubidri.. Cerebro vascular accident
Definitions ,[object Object],[object Object],[object Object]
Blood Supply to the Brain
Anterior Circulation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Posterior Circulation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Conditions Caused by Occlusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SMA Primary Motor cortex Primary Visual cortex (Broca’s area) Primary auditory  ortex (Wernicke’s area) Angular gyrus (Arcuate Fasciculus) Brain areas involved
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of  Stroke  Stroke Primary Hemorrhagic  (20% of Strokes) Primary Ischemic   (80% of Strokes) Thrombotic   53% Embolic   31% Intracerebral  Hemorrhage 10% Subarachnoid  Hemorrhage 6%
Primary Ischemic Stroke
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Thrombus
Embolus ,[object Object],[object Object],[object Object],[object Object],[object Object],Debris detaches    flows and lodges in artery
C E R E B R A l  A N E U R Y S M s
Pathogenesis Ischemic Cascade
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effects of Reduced CBF Normal ml/100g/min 50 – 55   25   20   15   8 Ischemia Edema   Loss of  Na/K+ pump ↑ lactate   electrical  failure; ↓ ATP   activity Penumbra Infarction Cell Death
Cerebral Infarction
Facial Weakness? Where is my lesion: summary? Spinal cord No Yes FW same side as limb W? Pons No Internal Capsule Yes Yes Leg and arm equal? No Cortical signs? Ipsilateral damage Contralateral damage Cortex Corona Radiata Yes No
Stroke Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stroke Mimickers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of Blood Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intravenous Thrombolysis  Tissue Plasminogen Activator (tPA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Administration of t-PA ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of t-PA ,[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical Treatment Craniotomy Aneurysm Clipping Aneurysm Coiling Endovascular Procedures
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Major Risk Factors Risk Factor Prevalence HTN Heart Disease 35% 10 – 120 % Previous CVA Carotid Bruit 2% 4% Diabetes Smoking 4-6% 25%
Unmodifiable Risk Factors for Stroke Age Incidence of stroke more than doubles each decade after age 55 Sex Incidence is about 30% higher for men than women
Rehabilitation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Emerging Therapies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AÉrÉÑuÉåïSÉå AqÉ×iÉÉlÉÉqÉç
 
 
[object Object],[object Object],[object Object],[object Object]
Remember……. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Case cva by dr guruprasad shetty