Stroke occurs when blood flow to the brain is interrupted, and there are two main types: ischemic (caused by blockage) and hemorrhagic (caused by bleeding). Stroke is a leading cause of long-term disability and death in the United States. Risk factors include high blood pressure, heart disease, smoking, and diabetes. Treatment depends on the type of stroke, but may involve clot-busting drugs or surgery to repair damaged blood vessels. Rehabilitation is important for recovery and aims to restore functions like movement, speech, and daily living skills through therapies.

1. STROKE AND ITS
TYPES
PREPARED BY Dr. Amjad PT

3. What Is Stroke ?
A stroke occurs when blood
flow to the brain is
interrupted by a blocked or
a burst blood vessel.

4. CVA
O Sudden loss of neurological function caused by
the interruption of blood flow to brain.
O Focal neurological deficits due to ischemia
O For classical stroke it must persist for at least 24
hours
O Paralysis (Hemiplegia)
O Weakness (Hemiparesis)
O Impairments (reversible) within 3 weeks
O Residual impairment (longer than 3 weeks)

5. What Is the Impact of Stroke?
O Stroke is the third leading cause of death in
the United States
O On average, someone suffers a stroke every
40 seconds
O About 795,000 Americans suffer a stroke
each year
O About every 4 minutes, someone dies of a
stroke

6. What Is the Impact of Stroke?
(Continued)
O Stroke is a leading cause of serious, long
disability
O About 6.4 million Americans are stroke
survivors

7. What Are the Types of Stroke ?
O Ischemic Stroke (Blockage)
O Caused by a blockage in blood vessels in
brain
O Hemorrhagic Stroke (Bleeding)
O Caused by burst or leaking blood vessels in
brain

8. What Are the Causes of
Ischemic Stroke?
O Begins with the development of fatty
deposits lining the blood vessel wall
O Thrombus: Development of blood clot at the
fatty deposit
O Embolus: Traveling particle too large to pass
through a small vessel

9. Embolic Stroke
Blood clot travels to the brain
Thrombotic Stroke
Blood flow is blocked to the brain

10. What Are the Causes of
Hemorrhagic Stroke?
O Occurs when a weakened blood vessel
ruptures
O Aneurysms: Ballooning of a weakened
region of a blood vessel
O Arteriovenous Malformations (AVMs):
abnormal blood vessels

11. Stroke Risk Factors
That Cannot Be Treated
O Age
O Sex
O Race
O Prior stroke
O Family history

12. Stroke Risk Factors That Can
Be Treated
O Hypertension/High Blood Pressure
O Heart Disease
O Cigarette Smoking
O Transient Ischemic Attacks
O Diabetes
O Elevated Blood Cholesterol/Lipids

13. Stroke Risk Factors
Less Well-Documented
O Geographical Location
O Socioeconomic Factors
O Excessive Alcohol Intake
O Certain Kinds of Drug Abuse

14. Stroke Warning Signs
O Sudden weakness or numbness of the face,
arm or leg, especially on one side of the body
O Sudden confusion, trouble speaking or
understanding
O Sudden trouble seeing in one or both eyes
O Sudden trouble walking, dizziness, loss of
balance or coordination
O Sudden, severe headaches with no known
cause (for hemorrhagic stroke)

15. ACAS
O Contralateral hemiparesis (LE more than UE)
O Contralateral hemi sensory loss (LE more
than UE)
O Incontinence
O Apraxia

16. MCAS
Contralateral hemiparesis (UE & face more than
LE)
Contralateral Hemi sensory loss (UE & face more
than LE)
Aphasia
Perceptual deficits

17. PCAS
• Contralateral homonymous hemianopsia
• Memory defect
• Hemiplegia
• Eye movements

18. Transient Ischemic Attacks
(TIAs)
O “Warning strokes” that can happen before a
major stroke
O Occur when blood flow through a brain
artery is blocked or reduced for a short time
O Symptoms are temporary but similar to
those of a full fledged stroke
O A person who has a TIA is 9.5 times more
likely to have a stroke

19. What Parts of the Brain
Are Affected by Stroke?
O LEG
O ARM
O BODY
O HAND
O FACE
O SPEECH
O READING
O SIGHT
O HEARING

20. What Are the
Effects of Stroke?
O Paralyzed left sight
O Spatial perceptual
defects
O Quick impulsive
behavioral style
O Memory deficits
O Right Brain

21. What Are the
Effects of Stroke?
O Paralyzed right side
O speech-language
deficits
O Slow cautious
behavioral style
O Memory deficits
O Left Brain

22. Motor deficits
O Early stages flaccidity, no voluntry movement
and no reflexes
O Cerebral shock lasts from 72 hours to 2 weeks
(can be longer)
O This is replaced by spasticity, hyperreflexia and
mass pattern (synergies )
O Bobath divided stroke into 3 stages
O 1-The initial flaccid stages
O 2-The stage of spasticity
O 3-The stage of relative recovery

23. How Are Strokes Treated?
O Ischemic Stroke
O • Clot-busters e.g., t-PA
O • Anticoagulants – warfarin
O • Carotid Endarterectomy
O • Angioplasty/Stents
O Hemorrhagic Stroke
O • Surgical Intervention
O • Endovascular Procedures, e.g., coils

24. Prevention of Stroke
O Control high blood pressure
O Prevent heart disease
O Stop cigarette smoking
O Recognize signs of TIA and tell physician
O Reduce blood cholesterol levels

25. Twitchell and Brunstrom
divided into 6 stages
Stage 1 periods of flaccidity , no movements
Stage 2 limb synergy ,minimal voluntary movement,
spasticity starts
Stage 3 control of synergy movement, spasticity
becomes severe
Stage 4 some movements without synergy happens,
spasticity decline
Stage 5 difficult movement pattern develops, spasticity
decreases
Stage 6 disappearance of spasticity, individual joint
movement possible, coordination, normal motor
function restored.
this stage is not for all patients

26. Rehabilitation
O After suffering a stroke,
it’s important to begin a
rehabilitation program
as soon as possible

27. Types of Rehabilitation
Programs
O Hospital programs
O Nursing facilities
O Outpatient programs
O Home-based programs

28. Rehabilitation Specialists
O Physician
O Rehabilitation nurse
O Physical therapist
O Speech therapist
O Occupational therapist
O Psychiatrist

29. Learn to recognize a stroke.
Time lost is brain lost.
Stroke is a medical emergency!
If you notice one or more stroke warning
signs,
GET HELP IMMEDIATELY