A stroke occurs when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from reaching the brain’s tissues. Without oxygen, brain cells and tissue become damaged and begin to die within minutes. Check out exactly how stroke effects the body. Strokes fall into three main categories: transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke. The MRI will help see if any brain tissue or brain cells have been damaged. A CT scan will provide a detailed and clear picture of your brain that shows any bleeding or damage in the brain. It may also show other brain conditions that could be causing your symptoms.

3. Presented By
Kalyankumar Msc (N)
Stroke

4. Introduction
 A Stroke occurs when the blood supply to part of your brain is
interrupted or severely reduced , depriving brain tissue of oxygen
and food , within minutes brain cells begin to die.
 Stroke is caused by the blockage of blood flow or rupture of an
artery in the brain.

5. Definition
 The term stroke is applied to acute severe manifestations of
cerebrovascular disease. WHO defined stroke as “rapidly
developed clinical signs of focal disturbance of cerebral function.
Lasting more than 24 hours or leading to death.

6. Incidence
 In 2008 it is estimated that cerebrovascular disease accounted for
6.1 million deaths world wide. Majority of these deaths occur in
the place people living in developed countries and 33.72% of
subjects were aged less than 70 years.

7. Risk factors
 1 Hypertension : This is considered as the main risk factor for
the cerebral thrombosis as well as cerebral haemorrhage.

8. Other factors:
Additional factors contributing to risk are cardiac
abnormalities(left ventricular hypertrophy , cardiac dilation

9.  Diabetes ,elevated blood lipids,

10.  Obesity Smoking

11. Risk factors
 Glucose intolerance , blood clotting and viscosity, oral
contraceptives etc.

12. TYPES
A . Ischemic stroke
1.Lacunar infarct.
2 .Carotid circulation obstruction
3 .Vertibro-basilar obstruction
B .Haemorrhagic stroke
1 .Spontaneous cerebral
haemorrhage
2 .Subarachnoid haemorrhage
3 .Intracranial aneurysm
4 .Arteriovenous malformation

13. Lacunar infract

15. Subarachnoid haemorrhage

16. Arterio venous malformation

17. Clinical features
 The disturbance of cerebral function is caused by Three
morphological abnormalities, i.e., Stenosis , occlusion or
rupture of Arteries. Dysfunction of brain manifests itself by
various Neurological signs and symptoms.

18.  Coma

19.  Hemiplegia, paraplegia, monoplegia, multiple paralysis,speech
disturbance, nerve paresis ,sensory impairment ,etc

21. Transcient ischaemic attacks (TIA)
 One phenomenon that has received increasing attention is the
occurrence of TIA in fair proportion of cases. These are
episodes of focal,reversible,neurological deficit of sudden onset
and of less than 24 hours duration.
 They show tendency to reccurence ,they are due to
microemboli and are a warning sign of Stroke.

22. HOST FACTORS
 A . Age: Stroke can occur at any age. Usually incidence rates rise
steeply with age. Globally about 47% of all stroke deaths occur in
persons over 70 years. In India, about one fifth of all strokes
occur below the age of 40 years called “ strokes in the young”.
 B .Gender : The incidence rates are higher in males than
females at all ages.
 C . Personal history : The WHO study showed that nearly
three-quarters of all registered stroke patient had associated
diseases, mostly in cardiovascular system or diabetes.
 This supports the view that in most cases stroke is merely an
incident in the slowly progressive course of a generalized vascular
disease.

23. Stroke control programme
 1 .The aim of stroke control programme is apply at community
level effective measures for the prevention of stroke.The first
priority goes to control of Arterial hypertension which is major
cause of stroke.
 As Transcient ischaemic attacks may be one the earliest
manifestations of stroke, their early detection and treatment is
important for the prevention of stroke.
 2. Control of Diabetes and elimination of smoking, and
prevention and management of other risk factors at the
population level are new approaches.

24.  Treatment for the acute stroke is largely control of complications.
Facilitate for the long term follow up of patients are essential. The
education and training of Health personnel and of the public form
an integral part of the programme.
 For any such programme, Reliable knowledge of the Extent of
the problem in the community concerned is essential.

27. Morbidity and mortality of Stroke