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Impaired cerebral circulation (Cerebral thrombosis (Pathophysiology…
Impaired cerebral circulation
Cerebral thrombosis
Definition
Is a sudden loss of brain function resulting from a disruption of the blood supply to a part of the brain.
Causes
Large artery thrombosis.
Small penetrating artery thrombosis.
Cardiogenic emboli.
Clinical manifestations
Loss of peripheral vision.
Hemiparesis.
Ataxia.
Dysarthria.
Paresthesia
Numbness or weakness of the face.
Change in mental status.
Risk factors
Obesity
Periodontal disease
Hyperlipidemia
Atrial fibrillation
Hypertension
Smoking
Pathophysiology
Decreased cerebral blood flow.
Aerobic respiration.
Neurons are unable to maintain aerobic respiration.
Anaerobic respiration.
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.
Loss of function.
Membrane pumps that maintain electrolyte balances fail and the cells cease to function.
Management
Surgical
Carotid endarterectomy.
Hemicraniectomy
Medical
Endotracheal Tube.
Hemodynamic monitoring
Neurologic assessment
Increased ICP.
Recombinant tissue plasminogen activator would be prescribed unless contraindicated.
Monitoring for bleeding.
Nursing
Prevent flexion.
Personal hygiene.
Prevent adduction.
Prevent edema.
Prevent venous stasis.
Be consistent in patient’s activities.
Full range of motion.
Diagnostic tests
CT scan
MRI.
Cerebral angiography.
Transcranial Doppler ultrasonography.
Skull x-ray.
Transient ischaemic attack
definition
Is a brief interruption of blood flow to part of the brain.
Causes
Brain hemorrhage
Blood clots
Embolus
Risk factors
family history
Smoking
Diabetes
High blood pressure
High cholesterol
Clinical manifestations
Double vision
Partial vision loss
Difficulty with balance and vertigo
Numbness of one half of the body
Acute onset of weakness
Acute change in level of consciousness or confusion
Diagnostic tests
Electrocardiogram (EKG)
Computerized tomography (CT scan)
Carotid ultrasound
Routine blood tests
complete blood count (CBC)
Physical examination and tests
Management
Nursing
Monitor vital signs at least every 15 minutes.
Treat hyperthermia with antipyretic medications.
Monitor for seizure activity, implement seizure precautions.
Support airway, breathing and circulation
Treat hyperglycemia to keep blood glucose levels between 140-180 mg/dL
Medical
Anticoagulants such asheparin and warfarin
Thrombolytic agents.
Surgical
Carotid endarterectomy
Cerebral embolism
Definition
When a blood clot that forms elsewhere in the body breaks loose and travels to the brain via the bloodstream.
Causes
Abnormal heart beat.
Blood clots
Atrial fibrillation
Clinical manifestations
Trouble walking
Numbness in the limbs or either side of the face.
Temporary paralysis
difficulty speaking
Risk factors
lack of exercise
drug use
Smoking
Obesity
High blood pressure
Diagnostic tests
CT scan.
Carotid ultrasound.
Cerebralangiogram.
Echocardiogram.
CT scan.
Mnagement
Surgical
Thrombectomy
Medical
Anticoagulants
Anti platelets
Nursing
Prevent flexion
Monitor vital signs
Pathophysiology