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A Nursing Approach in the
      Management of

CEREBROVASCUL
 AR DISORDERS


                       BY: DAVE JAY S.
                       MANRIQUEZ BSN,RN.
CEREBROVASCULAR
   DISORDERS
 An umbrella term that refers
to any functional abnormality
of the central nervous system
that occurs when the normal
 blood supply to the brain is
          disrupted.
STROKE
a sudden neurological
event which results in
   the new onset of
     neurological
      symptoms.
TYPES
   of
STROKE
ISCHEMIC
STROKE
 “BRAIN ATTACK”
MOTOR LOSS
-disturbance of voluntary
motor control on the side of
the body opposite the location
of the stroke lesion

•Hemiplegia
•Hemiparesis
COMMUNICATION LOSS
•Dysarthria
•Apraxia
•Agnosia
•Dysphasia or Aphasia
PERCEPTUAL DISTURBANCES
•Homonymous Hemianopsia
•Disturbance in Visual-Spatial Relations
      - Unilateral Neglect
•Loss of Peripheral Vision
•Night Blindness
•Diplopia
•Horner’s Syndrome
SENSORY LOSS
•Slight Impairment of Touch
•Loss of Proprioception
•Difficulty in interpreting visual,
tactile, and auditory stimuli
COGNITIVE IMPAIRMENT &
PSYCHOLOGICAL EFFECTS
ASSESSMENT & DIAGNOSTICS
•Patient History
•Complete Physical and Neurologic Examination
•Initial Assessment: Airway Patency,
Cardiovascular Status, Gross Neurologic Losses
•Stroke Time Course Classification
STROKE TIME COURSE
          CLASSIFICATION

Stage 1: Transient Ischemic Attack

Stage 2: Reversible Ischemic Neurologic Deficits

Stage 3: Stroke in Evolution

Stage 4: Completed Stroke
DIAGNOSTIC TESTS
•CT Scan
•12-Lead ECG
•Carotid ultrasound
•Cerebral Angiography
•Transcranial Doppler Flow Studies
•Transthoracic or Transesophageal Echocardiography
•MRI of the brain and/or neck
•Xenon CT
•Single Photon Emission CT
MEDICAL MANAGEMENT
•   Treatment of TIA from atrial fibrillation or
    suspected embolic or thrombotic causes
•   Thrombolytic Therapy for Ischemic Stroke
•   Therapy for Patients with Ischemic Stroke
    NOT Receiving Thrombolytic Therapy
•   Managing Potential Complications
SURGICAL MANAGEMENT

         CAROTID ENDARTERECTOMY
- Main surgical procedure for the management of
TIAs and small stroke
- Indicated for patients with symptoms of TIA or
mild stroke found to be due to carotid stenosis
- Complications: stroke, cranial nerve injuries,
infection, hematoma at the incision site, carotid
artery disruption
NURSING MANAGEMENT

•Improving Mobility and Preventing Joint Deformities
•Managing Sensory-Perceptual Difficulties
•Attaining Bowel and Bladder Control
•Improving Thought Processes
•Improving Communication
•Maintaining Skin Integrity
•Improving Family Coping
•Helping the Patient Cope with Sexual Dysfunction
HEMMORHAGIC
STROKE
CEREBRAL ANEURYSM
SUBARACHNOID HEMORRHAGE
Cerebrovascular disease
Cerebrovascular disease
Cerebrovascular disease
Cerebrovascular disease
Cerebrovascular disease
Cerebrovascular disease

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