Presentation on CVA

1. DIAGNOSTIC MEDICINE 2
STROKE MANAGEMENT-
CHOs 3Yr 2023
Dr. Brima Bobson Sesay
Medicine Department-NU

2. BRAIN DAMAGE
• Traumatic brain Injury (TBI)
• Stroke/Aneuryism
• Anoxia
• Cancer
• Disease
• Development

3.  Brain Ischemia: Results from vascular occlusion due to thromboembolic disease and
cerebral vascular abnormality preventing brain tissues from getting oxygen and nutrients.
 Transient ischemic attack (TIA) refers to temporary brain dysfunction lasting no longer
than 24 hours due to a shortage of blood and oxygen. It sometimes is referred to as a
"mini-stroke." TIA is a serious condition that serves as a warning for a stroke. About
30% of stroke patients have had a TIA at some point in the past.
 Reversible Ischemic Neurological Deficit(RIND): Is a type of stroke which lasts for
more than 24hours and settles within a week. They are important warning signs for the
development of cerebral infarction.
 Stroke/cerebrovascular accident (CVA) is a brain injury that occurs when the brain's
blood supply is interrupted. Without oxygen and nutrients from blood, brain tissue starts
to die rapidly (usually in less than 10 minutes), resulting in a sudden loss of function.
STROKE /CEREBROVASCULAR ACCIDENT

5. Stroke mechanism

7. Two Major Types of Stroke

8. Risk Factors
for Stroke
•High blood pressure (the number one risk factor for ischemic stroke)
•Drug abuse (heroin, cocaine , amphetamines)
•Narrowing of arteries supplying the brain due to atherosclerosis
•High cholesterol levels , particularly low-density lipoprotein (LDL)
cholesterol
•Smoking
•Diabetes mellitus
•Atrial fibrillation (abnormality of heart rhythm)
•Use of birth control pills if you are over 35 years old and smoke
•Long-term use of hormone replacement therapy*²

9. Symptoms of Stroke-
• Visual disturbances like blindness in one eye, and/or blurry, dimming or
double vision.
• Weakness, numbness, or tingling of the face, arm, leg, or one side of the body
(usually affects one side of the body, but there are exceptions).
• Difficulty speaking or understanding words
• Difficulty swallowing
• Dizziness, unsteadiness of gait, loss of balance or falling
• Trouble with balance or coordination
• Loss of consciousness
• Nausea and/or vomiting
• Sudden confusion or loss of memory
• Seizures
• Severe or unusual headache

10. GCS-gauging the severity of damage

14. RX for Stroke?
Medications
• Clot-dissolving drugs—given within three hours of the onset of symptoms. (Note: Only in carefully
selected patients.) Tissue plasminogen activator (tPA) is given through a vein after the doctor has
confirmed the stroke's cause and there is no evidence of bleeding.
• Blood-thinning drugs (Anticoagulants)—Clexane is given by subcutaneously (along with tPA, if
indicated) and an oral medication (warfarin) is sometimes started if long-term treatment with a
blood-thinner is anticipated.
• Antiplatelet drug— aspirin is the most common, but clopidogrel (Plavix), dipyridamole
(Persantine) are also sometimes used.
• Blood pressure medication(usually use Labetalol, the first-line drug, or sodium nitroprusside)
• Diabetes mellitus medication
• Drugs that reduce brain swelling
• Medication to control or correct irregular heart rhythm (such as atrial fibrillation)
• Cholesterol-lowering medications
•
Other interventions during an acute stroke include:
Providing adequate oxygen
Taking precautions to prevent choking
Frequent neurological examinations

15. Differential Diagnosis and Algorithm of management of Stroke

16. THE END!!!!!
• THANKS FOR YOUR ATTENTION….
QUESTIONS OR COMMENTS?