This content is about complete short term brief about cerebrovascular accident/stroke.These slides covers this whole topic from definition to management.

1. CEREBROVASCULAR
ACCIDENT
Ms. Shivnetri Chauhan
Nursing Tutor
Faculty of nursing, Rama university

2. DEFINITION
It occurs when there is ischemia to the part of brain or hemorrhage into the brain
that results in death of brain cells , functions such as movemet , sensation, that
were controlled by the affected area of brain.
ETIOLOGY
1. Non-modifiable
 Age
 Gender
 Race
 Family history
2. Modifiable
 Hypertension
 Lifestyle changes
 Heart diseases
 Smoking
 Excessive alcohol intake
 Obesity
 Sleep apnea

3. TYPES
1. Ischemic Stroke
• It results from inadequate blood flow to the brain from partial or complete occlusion of
an artery.
• It accounts for approx 80% of all strokes.
It is further divided into 2 types:
a. Thrombotic stroke
 It occurs from injury to a blood vessel wall and formation of blood clot.
 It occurs for about 60% of the stroke.
b. Embolic stroke
 It occurs when an embolus lodges in and occludes a cerebral artery resulting in
infarction and edema.
 It accounts for about 20% of all stroke.

4. Hemorrhagic Stroke
It accounts for approx 20% of all stroke and results from bleeding into brain tissues
itself or into sub-arachnoid spaces or ventricles.
It is divided into 2 types:
a. Intracerebral hemorrhage
• Bleeding within the brain caused by the rupture of blood vessel and accounts for
about 10% of all stroke.
• Prognosis is poor.
b. Sub-arachnoid hemorrhage
• It occurs when there is bleeding into the CSF filled spaces in the arachnoid and pia
matter hemorrhage on the surface of the brain mostly due to aneurysm.

5. CLINICAL MANIFESTATIONS
a. Motor Functions
 Impairment of mobility
 Impairment of respiratory functions.
 Impairment in swallowing and speech.
 Impairment in gag reflex and self-care ability.
 Loss of skilled voluntary movement.
 Alteration in muscle tone.
b. Communication
 Apraxia (inability to perform a previously learned behavior).
 Aphasia( loss of comprehension and use of language).
 Dysphasia( difficulty in swallowing).
 Dysarthria (difficulty in speaking).
c. Intellectual functions
 Both memory and judgment may be impaired.

6. DIAGNOSTIC EVALUATION
•CT-Scan
•MRI
•SPECT(Single Photon emission computerised tomography)
•PET(Positron Emitting Tomography).
•EEG
•CSF Analysis and angiography.
•CBC
TREATMENT
•Measure to prevent the development of thrombus.
•Aspirin is most frequently used antiplatelet drug.
Surgical Management
•Carotid endartectomy
•Transluminal angioplasty.

7. For ischemic stroke:
•Tissue plasminogen activator
For hemorrhagic stroke:
•Surgical decompression, clipping, wrapping of aneurysm.
For embolic stroke:
•Treatment of underlying cause.