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1. STROKE
TYPES & MANAGEMENT
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2. What Is Stroke ?
Astroke occurs when
blood flowtothe brain is
interrupted bya blocked
or a burst bloodvessel.
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3. STROKE
O Sudden loss of neurological function caused
by
the interruptionof blood flowtobrain.
O Focal neurological deficits due toischemia
O For classical stroke itmust persist forat least
24 hours
O Paralysis (Hemiplegia)
O Weakness (Hemiparesis)
O Impairments (reversible) within3 weeks
O Residual impairment (longer than 3 weeks)
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4. What Isthe Impact of Stroke?
O Stroke is thethirdleading cause of death
in the UnitedStates
OOn average, someone suffers a stroke
every 40 seconds
O About 795,000 Americans suffer a
stroke each year
O About every 4minutes, someone dies
of a stroke
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5. What Isthe Impact of Stroke?
(Continued)
OStroke is a leading cause of serious,
long disability
O About 6.4 million Americans are
stroke survivors
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6. Blood Supply of the Brain
• O Anterior: Carotid Arteries – middle & anterior cerebral
arteries
• frontal, parietal, temporal lobes; basal ganglion; part of the
diencephalon (thalamus & hypothalamus)
• O Posterior: Vertebral Arteries – basilar artery
• Mid and lower temporary & occipital lobes, cerebellum,
brainstem, & part of the diencephalon
• O Circle of Willis – connects the anterior & posterior
cerebral circulation
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7. What Are the Types of Stroke?
O Ischemic Stroke(Blockage)
O Caused bya blockage in blood
vesselsin brain
OHemorrhagic Stroke(Bleeding)
O Caused byburst or leaking blood
vesselsin brain
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8. What Are the Causesof Ischemic Stroke?
O Begins withthe development of
fatty deposits lining the blood
vesselwall
O Thrombus: Development of blood clotat
the fatty deposit
O Embolus: Travelingparticle too large to
pass through a smallvessel
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9. EmbolicStroke
Blood clottravels tothebrain
Thrombotic Stroke
Blood flowis blocked tothebrain
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10. What Are the Causesof Hemorrhagic Stroke?
O Occurs when a weakened blood
vessel ruptures
O Aneurysms: Ballooning of a
weakened region of a bloodvessel
O Arteriovenous Malformations
(AVMs): abnormal bloodvessels
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11. Stroke Risk Factors That Cannot BeTreated
O Age
O Sex
O Race
O Prior stroke
O Familyhistory
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12. Stroke Risk Factors That Can Be Treated
O Hypertension/High BloodPressure
O Heart Disease
O CigaretteSmoking
O Transient Ischemic Attacks
O Diabetes
O Elevated Blood Cholesterol/Lipids
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13. Stroke Risk Factors Less Well-Documented
O Geographical Location
O Socioeconomic Factors
O Excessive AlcoholIntake
O Certain Kinds of DrugAbuse
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14. Stroke Warning Signs
O Sudden weakness or numbness of the face, arm
or leg,especially on one side of thebody
O Sudden confusion, trouble speakingor
understanding
O Sudden trouble seeing in oneor both eyes
O Sudden trouble walking, dizziness, lossof
balance orcoordination
O Sudden, severe headaches withnoknown
cause (forhemorrhagicstroke)
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15. ACAS
O Contralateral hemiparesis (LE more thanUE)
O Contralateral hemi sensory loss (LEmore
than UE)
O Incontinence
O Apraxia
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16. MCAS
O Contralateral hemiparesis (UE & face more
than LE)
O Contralateral Hemi sensory loss (UE & face
more than LE)
O Aphasia
OPerceptual deficits
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17. PCAS
O Contralateral homonymoushemianopsia
O Memory defect
O Hemiplegia
O Eye movements
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18. Transient Ischemic Attacks
(TIAs)
O “Warning strokes” that can happen
beforea majorstroke
O Occur when blood flowthrough a brain
artery is blocked or reduced forashort
time
O Symptoms are temporary but similar
to those of a fullfledgedstroke
O Aperson who has a TIAis 9.5 times
more likely tohave a stroke
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19. Motor deficits
O Early stages flaccidity,no voluntry
movement and noreflexes
O Cerebral shock lasts from 72 hours to2
weeks (can be longer)
O This is replaced byspasticity, hyperreflexia
and
mass pattern (synergies)
O Bobath divided stroke into 3stages
O 1-The initialflaccid stages
O 2-The stage ofspasticity
O 3-The stage of relativerecovery
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20. Diagnosis
• CT Scan
• MRI
• Angiography
• Lumbar Puncture
• USD
• Echocardiogram
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21. How Are Strokes
Treated?
O • Ischemic Stroke
O• Clot-busters e.g.,t-PA
O• Anticoagulants – warfarin
O• CarotidEndarterectomy
O• Angioplasty/Stents
O• Hemorrhagic Stroke
O• SurgicalIntervention
O• Endovascular Procedures,e.g.,coils
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22. Prevention of Stroke
O Control high bloodpressure
O Prevent heartdisease
O Stop cigarettesmoking
O Recognize signs of TIAand tellphysician
O Reduce blood cholesterollevels
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23. Rehabilitation
O Aftersuffering a stroke,
it’simportant tobegin a
rehabilitation program
as soon aspossible
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24. Types of Rehabilitation Programs
O Hospital programs
O Nursing facilities
O Outpatient programs
O Home-based programs
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25. Rehabilitation Specialists
O Physician
O Rehabilitation nurse
O Physical therapist
O Speech therapist
O Occupationaltherapist
O Psychiatrist
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26. THANK YOU
Presented By
Rohit Bhaskar
Physiotherapy Student
At Uttar Pradesh University
Of Medical Sciences
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