condition and treatment of stroke

1. CONDITIONS AND
TREATMENTS OF STROKE
Presented by:- Afsana , isha kareem, sara bibi, unsa memon,Noorulain
Roll no:- 66 to 70

2. STROKE
 A Stroke is rapid loss of brain function due
to the disturbance in the blood supply to
brain .
 A stroke happens when blood flow to a part
of the brain stops and it is sometimes called
“ brain attack’.
 A stroke is the medical emergency and
treatment must be sought as quickly as
possible.
 Stroke can cause brain damage, long-term
disability , even death.

3. The most common types of disabilities after stroke are;
 Impaired speech
 Restrickted physical activities
 Weakness or paralysis of limb on one side of the body ( leg ,arm)
 Difficulty in gripping or holding things
 Slowed ability to communicate

4. Risk factors
MODIFIABLE : FIXED :
 High blood pressure > age
 Heart disease(heart failure , > gender(male>female)
endocarditis) > heredity
 Diabetes mellitus
 Hyperlipidemia
 Excess alcohol consumption
 Smoking
 obesity, sedentary lifestyle

5. HEMORRHAGIC STROKE
ISHA KAREEM
DPT/1-21/074

6. HEMORRHAGIC STOKE
Hemorrhagic stroke occurs when a weakened Blood vessels
in the brain that leaks and ruptures and
And bleed in to surrounding Brain.
Two TYPE OF HEMORRHAGIC STROKE
1. Subarachnoid Hemorrhagic
2.Intracerebral Hemorrhagic

8. TWO TYPE OF HEMORRHAGIC STROKE
1.Subarachnoid Hemorrhagic..
Bleeding happened in the area
between the Brain and skull.
2. Intracerebral Hemorrhagic..
Bleeding inside the brain .

9. CAUSES OF HEMORRHAGIC STROKE
 High blood pressure.
 Injury.
 Bleeding disorder.
 Abnormal blood vessels (AVMs).
 Aneurysm( A weak area in the Artery).

10. SYMPTOMS OF HEMORRHAGIC STROKE
 Sudden and Severe headache.
 Vision problem , Inability to look at bright light.
 Loss of balance and coordination.
 Becoming Unable to move.
 Numbness and weakness on one side of body , stiffness
or pain in the neck area .
 Confusion and loss of alertness.
 Loss of speech or Difficulty understanding speech.
 Nausea and vomiting and change in heartbeat and breathing .

11. DIAGNOSIS OF HAEMORRHAGIC STROKE
 HAEMORRHAGIC stroke
Can be diagnose by
two ways
1 CT scan
2 MRI

12. For subarchnoid haemorrhag For intercerebral haemorrha

13. Treatment of Hemarrhogic stroke
 Medications used in the treatment of haemorrhagic
stroke are
 anticonvulsants such as diazepam, to prevent
seizure recurrence
 antihypertensive agents such as labetalol, to reduce
blood pressure (BP) and other risk factors for heart
disease
 osmotic diuretics such as mannitol, to decrease
intracranial pressure in the subarachnoid space.

14. Surgery procedure of haemorrhagic
stroke
Craniotomy
It is for relieving intercranial
pressure
When there is bleed near the
surface of the skull
The part of the skull bone
remove And show brain to
drain any accumlate blood and
relive pressure .
FOR CRANIOTOMY ANGIOGRAPHY
IS DIAGNOSING METHOD TO FIND
EXACT LOCATION WHERE BLOOD
ACCUMLATE IN THE BRAIN TISSUE

15.  STAREOTACTIC ASPIRATION
It is surgical procedure used
when bleed that’s located
deep In the Brain tissue
drain to relive pressure
It is done under CT scanner
to help guide a needle to the
exact spot where blood
needs to be drain

16. Physiotherapy after haemorrhagic stroke
 Physiotherapy Play important part of
rehabilitation following stroke. Physiotherapy can
help restore loss of movement following a stroke.
It can help person regain strength and
movement, enabling person to be as independent
as possible.

17. Physical exercise after stroke
1 Stationary cycling for
 Improved memory and brain
functioning.
 Lower blood pressure.
2. Walking Outside or on treadmill For
 Improves Heart health
 Weight loss
 Strengthens your muscles
 Balance

18.  Recumbent cross training
recumbent cross trainig provides a
low-impact, full-body workout with
multiple resistance levels to challenge
Person as person’s fitness level
improves. Increasing resistance will
help Person strengthen muscles
which in turn, will help To improve
balance and coordination
AND ALSO SOME MANUAL EXERCISE FOR
, UPPER AND LOWER EXTREMETRIES

19. Ischemic stroke
▶ This type of stroke is caused by a blockage in a artery that supplies blood to
the brain.
▶ The blockage is reduces the blood flow and oxygen To the brain , Leading to
the damage or death of brain cell
▶ If circulation Is not restore quickly, Brain damage can be permanent.
▶ About 85% fall in to this category.

20. Cause of ischemic stroke
▶ Atherosclerosis:
▶ Fatty deposits lining In the blood vessels wall is called atherosclerosis
▶ Hypertension
▶ Smoking
▶ . Diabetes
▶ . High cholesterol
▶ . Obesity
▶ . Physical inactive

21. Types of ischemic stroke
▶ Thrombotic stroke :
▶ It is caused by blood clot that forms in an artery that supplies blood to the
brain.
▶ • Embolic stroke :
▶ It happen when a Clot form somewhere else In the body and travel through
the blood vessels to the brain. It gets stuck there and stop the blood flow.

22. Sign and symptoms

23. Treatment of
ischemic stroke
Presented by:- Noorulain
Enrollment no:- DPT/1-21/070

24. Diagnosis of ischemic stroke
 Blood tests. You may have several blood tests, including tests to check how fast the blood
clots, whether the blood sugar is too high or low, and whether you have an infection.
 Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed
image of your brain. A CT scan can show bleeding in the brain, an ischemic stroke, a tumor or
other conditions. Doctors may inject a dye into your bloodstream to view the blood vessels in
the neck and brain in greater detail (computerized tomography angiography).
 Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and a magnetic field to
create a detailed view of the brain. An MRI can detect brain tissue damaged by an ischemic
stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to view the
arteries and veins and highlight blood flow (magnetic resonance angiography or magnetic
resonance venography).
 Carotid ultrasound. In this test, sound waves create detailed images of the inside of the
carotid arteries in the neck. This test shows buildup of fatty deposits (plaques) and blood
flow in the carotid arteries.
 Cerebral angiogram. In this uncommonly used test, your doctor inserts a thin, flexible tube
(catheter) through a small incision, usually in the groin, and guides it through the major
arteries and into the carotid or vertebral artery. Then your doctor injects a dye into the
blood vessels to make them visible under X-ray imaging. This procedure gives a detailed view
of arteries in the brain and neck.
 Echocardiogram. An echocardiogram uses sound waves to create detailed images of the
heart. An echocardiogram can find a source of clots in the heart that may have traveled from
the heart to the brain and caused a stroke.

25. TREATMENT OF ISCHEMIC STROKE
When it comes to treating ischemic stroke, time is of the essence. The longer a
patient goes without treatment, the more damage is done to the brain. That's
why it's crucial to seek medical attention immediately if you suspect you or
someone else is having an ischemic stroke.
 Two common treatments for ischemic stroke are thrombolytic therapy and
mechanical thrombectomy. Thrombolytic therapy involves administering
medication that dissolves blood clots and improves blood flow to the brain.
Mechanical thrombectomy involves physically removing the clot from the
blocked artery using a catheter-based procedure. Both of these treatments
can be highly effective in restoring blood flow to the brain and minimizing
damage.

26.  Emergency IV medication. Therapy with drugs that can break up a clot has to be
given within 4.5 hours from when symptoms first started if given intravenously.
The sooner these drugs are given, the better. Quick treatment not only improves
your chances of survival but also may reduce complications.
 An IV injection of recombinant tissue plasminogen activator (TPA)— is the gold
standard treatment for ischemic stroke. An injection of TPA is usually given
through a vein in the arm within the first three hours. Sometimes, TPA can be
given up to 4.5 hours after stroke symptoms started.
 This drug restores blood flow by dissolving the blood clot causing the stroke. By
quickly removing the cause of the stroke, it may help people recover more fully
from a stroke. Your doctor will consider certain risks, such as potential bleeding in
the brain, to determine whether TPA is appropriate for you.
 Emergency endovascular procedures. Doctors sometimes treat ischemic strokes
directly inside the blocked blood vessel. Endovascular therapy has been shown to
significantly improve outcomes and reduce long-term disability after ischemic
stroke. These procedures must be performed as soon as possible:
 Medications delivered directly to the brain. Doctors insert a long, thin tube
(catheter) through an artery in the groin and thread it to the brain to deliver TPA
directly where the stroke is happening. The time window for this treatment is
somewhat longer than for injected TPA but is still limited.
 Removing the clot with a stent retriever. Doctors can use a device attached to a
catheter to directly remove the clot from the blocked blood vessel in the brain.
This procedure is particularly beneficial for people with large clots that can't be
completely dissolved with TPA. This procedure is often performed in combination
with injected TPA.

27.  To decrease your risk of having another stroke or transient ischemic attack,
your doctor may recommend a procedure to open up an artery that's
narrowed by plaque. Options vary depending on the situation, but include:
 Carotid endarterectomy. Carotid arteries are the blood vessels that run along
each side of the neck, supplying the brain (carotid arteries) with blood. This
surgery removes the plaque blocking a carotid artery and may reduce the risk
of ischemic stroke. A carotid endarterectomy also involves risks, especially for
people with heart disease or other medical conditions.
 Angioplasty and stents. In an angioplasty, a surgeon threads a catheter to the
carotid arteries through an artery in the groin. A balloon is then inflated to
expand the narrowed artery. Then a stent can be inserted to support the
opened artery.
 https://youtu.be/WMMLMunoT1c

28. Medications used to treat ischemic stroke
 Aspirin and other antiplatelets
 Most people will be given aspirin straight after having an ischaemic stroke. As well as being a
painkiller, aspirin is an antiplatelet, which reduces the chances of another clot forming.
 Other antiplatelet medicines may be used later, such as clopidogrel and dipyridamole.
 Anticoagulants
 Some people may be offered an anticoagulant to help reduce their risk of developing new
blood clots in the future.
 Anticoagulants prevent blood clots by changing the chemical composition of the blood in a
way that prevents clots from forming.
 Warfarin, apixaban, dabigatran, edoxaban and rivaroxaban are examples of anticoagulants
for long-term use.
 Blood pressure medicines
 If your blood pressure is too high, you may be offered medicines to lower it.
 Medicines that are commonly used include:
 thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, calcium channel
blockers, beta blockers, alpha-blockers
You'll usually be advised to take a medicine known as a statin.Statins reduce the level of
cholesterol in your blood by blocking a chemical (enzyme) in the liver that produces cholesterol.

29. Rehabilitation after ischemic stroke
 Introduction
 Ischemic stroke is a medical emergency that requires immediate treatment. After the acute
phase, rehabilitation plays a crucial role in the recovery process. The goal of rehabilitation is
to help patients regain their independence and improve their quality of life. This guide
provides a comprehensive overview of rehabilitation after ischemic stroke, including the
different types of therapies, their benefits, and how to access them.
 Types of Rehabilitation Therapies
 There are several types of rehabilitation therapies that can help patients recover from
ischemic stroke:
 Physical therapy: Helps patients improve their mobility, strength, and balance through
exercises and activities.
 Occupational therapy: Helps patients regain their ability to perform daily activities, such as
dressing, grooming, and eating.
 Speech therapy: Helps patients improve their communication skills and ability to swallow.
 Benefits of Rehabilitation
 Rehabilitation after ischemic stroke has several benefits, including:
 Improved mobility and independence
 Reduced risk of complications, such as blood clots and pneumonia
 Improved quality of life.

30. Preventing after ischemic stroke
 Ischemic stroke is a serious condition that can have devastating
consequences. Fortunately, there are steps you can take to reduce your risk
of having a stroke. One of the most important things you can do is to maintain
a healthy lifestyle. This includes eating a balanced diet, getting regular
exercise, and avoiding smoking and excessive alcohol consumption.
 In addition to these lifestyle changes, there are also medical interventions
that can help prevent ischemic stroke. For example, if you have high blood
pressure or high cholesterol, it's important to work with your doctor to
manage these conditions. Medications such as statins or blood thinners may
be prescribed to help lower your risk of stroke. In some cases, surgery may be
recommended to remove blockages in the arteries that supply blood to the
brain.