A stroke occurs when blood flow to the brain is interrupted by a blocked or burst blood vessel. There are two main types of stroke - ischemic, caused by a clot blocking a vessel, and hemorrhagic, caused by a ruptured vessel. The goal of acute stroke treatment is to rapidly restore blood flow to the brain to rescue tissue at risk of further damage. Treatment depends on the type and severity of stroke, and may involve clot-busting drugs, blood thinners, surgery, or rehabilitation therapies to help recovery.

1. MEGHANA C
DOTT, BOTT, M.Sc Medical
Biochemistry
Cerebro Vascular
Accident

2. What Is Stroke ?
 A stroke occurs when blood flow to the brain is
interrupted by a blocked or burst blood vessel
 When brain tissue is deprived of blood flow,
neurons die within minutes. Surrounding a core of
infarction is an “ischemic penumbra,” poorly
perfused but viable tissue at risk for imminent
infarction.
 The goal of acute stroke care is the revival and
rescue of the ischemic penumbra by rapid
restoration of blood flow. The goal of acute stroke
care is the revival and rescue of the ischemic
penumbra by rapid restoration of blood flow.

3. Causes
 If blood flow is stopped for longer than a few
seconds the brain cannot get blood and oxygen
brain cells can be causing permanent damage
Types of stroke
There are two major types of stroke namely;
 Ischemic stroke and
 Hemorrhagic stroke

4. TYPES OF STROKE

5. ISCHEMIC STROKE
 Ischemic stroke occurs when a blood vessel that supplies
blood to the brain is blocked by a blood clot,
 This may happen in two ways;
1. Thrombotic stroke
2. Embolic stroke (cerebral embolism)
1. Thrombotic stroke
a blood clot from thrombosis may form in an artery that is
already very narrow this is called a thrombotic stroke in
this case sufficient amount of blood is not supplied to the
brain resulting in stroke.
2. Cerebral embolism or an embolic stroke
A clot may break off from another place in the artery blood
vessel of the brain (one of the complication of aneurysm)or
some other part of the body and travel up to the brain this
is called cerebral embolism or an embolic stroke.

6. HEMORRHAGIC STROKE
 A hemorrhagic stroke is also called an
intracerebral hemorrhage, or an ICH. An ICH
occurs when a blood vessel ruptures and blood
accumulates in the tissue around the rupture.
This puts pressure on the brain and causes a loss
of blood to the surrounding areas.
 High blood pressure and trauma are two leading
causes. Taking blood-thinning drugs may also
increase a person's risk.
 Symptoms can vary based on the location of the
haemorrhage in the brain, but may include
numbness or weakness in part of the face,
difficulty speaking or difficulty walking.

7. DIAGRAMATIC REPRESENTATION OF CVA TY

8. STROKE RISK FACTOR
 High blood pressure is the number one risk factor
for stroke
 Diabetes mellitus
 Family history of stroke
 High cholesterol
 Increasing age especially after age 55
 Race (black people are more likely to die of
stroke)
 Birth control pills contraceptive pills can increase
the chances of having blood clot
(thrombosis).The risk is highest in women who
smokes and are older than 35 years
 Cardiac patients or patients with poor blood flow

10. THE CHANCE OF STROKE IS HIGHER IN
PEOPLE WHO LIVE AN UNHEALTHY
LIFESTYLE BY ;
 BEING OVERWEIGHT OR OBESE
 DRINKING HEAVILY (ALCOHOLIC)
 EATING TOO MUCH OF SALT OR FAT
 SMOKING
 DRUG ADDICTS (TAKING COCAINE AND
OTHER ILLEGAL DRUGS)

11. STROKE SYMPTOMS
 The symptoms of stroke depend on what part of the brain
is damaged. In some cases a person may know that he or
she has had a stroke.
 Headache occur especially if the stroke is caused in the
brain by bleeding
 Change in alertness (sleepiness and consciousness and
coma)
 Changes in hearing
 Changes in taste
 Clumsiness
 Vertigo
 Muscle weakness in the face arm or leg (usually one side)
 Lack of control over the bowel or bladder
 Problem with vision including decreased vision and
 Numbness on one side of the body

13. DIAGNOSIS OF CVA
1. Physical examination
2. Lab test

14. PHYSICAL EXAMINATIONS
INCLUDE;
 Check the BP which may be high
 Listen for abnormal sound called "BRUIT" by
using a stethoscope, listen to carotid artery in the
neck - a "BRUIT" is caused by abnormal blood
flow
 Check for problems with vision moment feelings
reflexes understanding and speaking

15. LAB TEST INCLUDES
 Bleeding time BT
 Blood cholesterol
 Blood sugar
 Blood clotting test (prothrombin time, or partial
thromboplastin time)
 Complete blood count
 ECG
 Heart rhythm monitoring

16. FOLLOWING TESTS CAN HELP TO FIND
THE TYPE LOCATION AND CAUSE OF THE
STROKE
 Angiogram of the head can show which blood
vessels is blocked or bleeding
 Carotid duplex ultrasound can show carotid
arteries in the neck have narrowed
 CT scan of the brain
 MRI scan
 Echocardiogram may be done if the stroke could
have been caused by a blood clot from the heart
 Magnetic resonance angiography (MRA) or CT
angiography may be done to check for abnormal
blood vessels in the brain.

17. COMPLICATIO
N
 Loss of moment
or feeling in one
or more part of
body
 muscle spasticity
 problem
speaking and
understanding
 problem thinking
and focusing
 loss of mobility

19. TREATMENT FOR CVA -
STROKE
 Stroke is a medical emergency immediate treatment can
save life and reduce disability
 Treatment depends on how severe the stroke was and
what caused it a bleeding (hemorrhagic) or A clot
(ischemic, thromboembolic)
 Thrombolytic therapy :-
 If if the stroke is caused by a blood clot, a blood clot
bursting drug or (thrombolytic drugs) may be given to
dissolve the clot.
 These medicines breaks up blood clot and helps bring
back blood flow to the damaged area.
 However,everyone can not get this type of medicine. For
these drugs to work a treatment must begin within 3 hours
when the symptoms first started.
NOTE: A CT scan must be done to see whether the stroke is
from A clot

20. TREATMENT FOR CVA -
STROKE
 Blood thinners such as a heparin or warfarin
may be used to treat stroke due to blood clots
 Aspirin or clopidogrel(plavix) may also be used
 Other medicines may be used to control
symptoms which has high BP
 If bleeding occured, surgery is often needed to
remove blood from around the brain and fix
damaged blood vessels.
 Surgery on the carotid artery may be needed
 Physical therapy, occupational therapy, speech
therapy and swallowing therapy will begin in
hospital.
 Precautions and clothes prevention of further