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NOOR HAZILAH BT OMAR
• Also known as cerebrovascular accident (CVA).
• A stroke is the sudden death of brain cells in a
localized area due to inadequate blood flow.
• Sudden onset of neurological sign and
symptoms, usually focal and acute.
• It involve blood vessels which can cause
temporary or permanent loss of function.
(World Health Organization, 1989)
• Diabetes Mellitus
• Heart disease
• Cigarette or other tobacco use. Cigarettes
cause the carotid arteries to develop severe
atherosclerosis or to close. Atherosclerosis is
accelerated by smoking.
• Head injury
- Often d/t HPT &
combination of weakness of
vessel wall & lead to
-gradual occlusion of blood
vessel (slow onset of
- d/t berry aneurysm with
hemorrhage into subarachnoid
Block of blood vessel
to the brain
Types of stroke
-Interruption of blood supply
depress oxygen and nutrient to
brain cell and make severity
brain death/ damage depending
on total blood supply lack.
- Ischemic embolism
- Ischemic thrombotic
- lacunar syndrome
-d/t burst of blood vessel that
- commonly d/t aneurysm & TIA
- Intracerebral haemorrhage
Classification of Stroke
• 1) Transient Ischemic Attack
– Acute of focal cerebral or monocular function with
symptoms lasting <24 hr.
– The patient may not loss consciousness and there may
be an initial weakness of muscles.
• 2) Cerebral Hemorrhage /CVA
– A cerebral hemorrhage occurs when a blood vessel in
the brain ruptures and bleeds into the surrounding
– Rapidly developing clinical symptoms lasting > 24hr
• 3) Arteriosclerotic dementia
- Deterioration in previously normal
memory/intellect d/t repeated episode of
cerebral ischemic infarction or hemorrhage
( Ann thompson,1994)
• Sudden numbness or weakness of face, arm or leg, especially on
one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause
Other important but less common symptoms include:
• Sudden nausea, and vomiting - different from a viral illness because
of how fast it begins (minutes or hours vs. several days)
• Brief loss of consciousness or a period of decreased consciousness
(fainting, confusion, convulsions or coma)
(National Stroke Association)
Atheroma cause the narrowing of arteries
Cause increase in blood pressure
Rupture of the vessel.
Internal bleeding – blood clot or hematoma
Brain cell damage
• CT Scan –Computed Tomography Scan
• MRI-Magnetic Resonance Imaging.
• MRA-Magnetic Resonance Angiography.
• Lumbar Puncture-CSF test.
• Medical –antibiotics ,IV Methanol .
• Surgical –Craniotomy, Vascular reconstructive
surgery, Clipping of rupture aneurysm.
1)Prevent recurrent stroke
2)Monitor vital signs, dysphasia adequate nutrition, bladder &
4)Mobilize the patient
5)Encourage resumption of self-care activities
6)Provide emotional support & education for patient & family
7)Screen for rehabilitation and choice of settings
1)Set rehabilitation goals; develop rehabilitation plan and
2)Manage sensory-motor deficits
3)Improve functional mobility & independence
4)Prevent & treat complications
5)Monitor functional health conditions
6)Discharge planning (safe residence recommendation,
patient & caregivers education & continuity of care)
7)Community – reintegration
(Physiotherapy Practice Guidelines for Stroke Rehabilitation,