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Ischemic strokes (Diagnoses (angiography (angiography), Lumbar puncture…
Ischemic strokes
Diagnoses
MRI or CT
angiography
Lumbar puncture
is there blood?
Doppler ultrasound
Clinical neurological examination
Symptoms
Apraxia
Ideatoric
Ideomotor
Oral buccal apraxia
Neglect
Can be visual, auditory somatosensory and motor modalities
Aphasia
language problem
95% left side brain
Assessment
Naming
Repetition
Comprehension
Reading and writing
Fluency
Constructional apraxia
right partial lobe
no manipulation possible of objects
Arosody
affective aspects of communication
changed in personalitu
Treatment
Clot dissolving drugs
Whitin 3 hours
TPA Intravenous tissue plasminogen activator
Intraarterial thrombolysis
TPA directly injected in bloodclot
up to 6 hours onset
Anticoagulant treatment
Heparin inj.
Aspirin
Angioplasty
katheter
Carotid endarterectomy
surgically removed
when blockage more then 70%
ischemic strokes
Types
Silent stroke
Lacuner infarcts
small infarct in deeper part brain
25% of al ischemic strokes
Atherosclerosis
Transient ischemic stroke
TIA
no neuroimigaing found
90-day risk of stroke after TIA: 7%
Brain abnormalities
lasts longer then 24 hours
abrupt onset or focal
88% first stroke
12 arterial arteries
Etiology
global decreased perfusion
Oedema of the brain worst 3-5 day
mechanisms
Carotid artery narrows
piece plaque breaks and get stuck smaller arterie
