Believe in. Yourself

1. C A S E P R E S E N TAT I O N O N C E R E B R O - VA S C U L A R A C C I D E N T
By
Ankita Bandopant
Karnewar

3. INTRODUCTION
What is the brain? The brain is a complex organ that controls
thought, memory, emotion, touch, motor skills, vision, breathing,
temperature, hunger and every process that regulates our body.
Together, the brain and spinal cord that extends from it make up the
central nervous system, or CNS.

5. LOREM IPSUM
DEFINITION :
The sudden death of brain
cells due to lack of O2 when
the blood flow to the brain is
impaired by blockage or
rupture of an artery to the
brain.

6. 🌼Classification
Strokes can be divided into two classifications.
Ischemic stroke :-This is the loss of function in the
brain as a result of a disrupted blood supply.
Hemorrhagic stroke :- Hemorrhagic strokes are
caused by bleeding into the brain tissue, the
ventricles, or the subarachnoid space.

7. 👉🏻 cerebral hemorrhage
👉🏻 cerebral thrombosis
👉🏻 family history
👉🏻 age
👉🏻 gender
👉🏻 hypertension
👉🏻 obesity
👉🏻 drugs, alcohol, smoking
ETIOLOGY

8. PATHOPHYSIOLOGY
1)Decreased cerebral blood flow :- The
ischemic cascade begins when cerebral blood
flow decreases to less than 25 mL per 100g of
blood per minute.

9. 2) Aerobic respiration :- At this point,
neurons are unable to maintain
aerobic respiration.

10. 3) Anaerobic respiration :- The mitochondria
would need to switch to anaerobic respiration,
which generates large amounts of lactic acid,
causing a change in pH and rendering the
neurons incapable of producing sufficient
quantities of ATP.

11. 4) Loss of function :- The membrane
pumps that maintain electrolyte balances
fail and the cells cease to function.

12. Clinical manifestation
👉🏻 face drooping
👉🏻 arm weakness
👉🏻 speech difficulty
👉🏻 loss of voluntary
movement
👉🏻 numbness
👉🏻 impaired walking

13. DIAGNOSTIC
EVALUATION
✨ history taking
✨ CT scan
✨ ECG
✨ RFT
✨ LFT
✨ MRI
✨ lumbar puncture

14. Management
1) Medical management
- anti hypertension
- anti diabetic
- treatment of underlying cardiac problem
- smoking cessation

15. Increased ICP :- Management of increased ICP
includes osmotic diuretics, maintenance of PaCO2
at 30-35 mmHg, and positioning to avoid hypoxia
through elevation of the head of the bed.

16. 2) Surgical management
- carotid endarterectomy
- Simple and complex intracranial bypass procedures
- Craniectomy and hemispheric decompression for stroke
patient

17. 3) Nursing management
- Assess mental status and level of consciousness.
- Observe for neurological deficits with frequent and
serial neurological assessments.
- Measure and monitor pupil size.
- Assess breathing.
- Monitor vital signs.
- Assess higher functions like speech, memory, and
cognition.

18. - Prevent adduction. Prevent adduction of the affected
shoulder with a pillow placed in the axilla.
- Prevent edema. Elevate affected arm to prevent edema
and fibrosis.
- Full range of motion. Provide full range of motion four or
five times a day to maintain joint mobility.

19. - Prevent venous stasis. Exercise is helpful in
preventing venous stasis, which may
predispose the patient to thrombosis and
pulmonary embolus
- Personal hygiene. Encourage personal
hygiene activities as soon as the patient can sit
up.

20. T H A N K Y O U F O R W A T C H I N G