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Stroke - Coggle Diagram
Stroke
complications of stroke
also having awareness about prevention methods to prevent the disease from occurring at the first place
clinical depression
brain edema
deep venous thrombosis
Pneumonia
swallowing problems
seizures
UTI
bedsores
limb contractures
shoulder pain
signs and symptoms of stroke
resulted from certain events
sudden trouble seeing
F.A.S.T
Arm drift
Speech abnormality
Facial drooping
Time of symptom onset
sudden trouble walking
sudden severe headache
sudden confusion
sudden numbness
prevention of strokes
thus decreasing the prevalence of the disease
exercise
stop smoking
diet
low cholesterol
stop drinking alcohol
treat underlying conditions
avoid stress
epidemiology of strokes
87% of strokes are ischemic
13% of strokes are hemorrhagic
strokes can happen at any age
in 2019 there were 6.6 million deaths attributable to cerebrovascular disease worldwide
Autoregulation of cerebral circulation
abnormalities might lead to
Metabolic regulation
metabolic factors involved in the regulation of the cerebral blood flow
H+ concentration
O2 concentration
CO2 concentration
Neurogenic regulation
sympathetic stimulation
substances released from astrocytes
The ability of the brain to maintain relatively constant blood flow despite changes in perfusion pressure
investigations for strokes
to give the proper treatment
Brain imaging
MRI
non-contrast CT
Lab testing
coagulation studies
CBC
basic chemistry panel
other tests for selected patients
ECG
cardiac biomarkers
fasting lipid profile
toxicology
chest x-ray
pregnancy test
EEG
arterial blood gas
blood alcohol level
lumbar puncture
managements of stroke
also treating the psychosocial problems
pharmacological
for acute ischemic stroke
IV tPA
within 3-4.5 hours of onset
Aspirin
within 24-48h after onset
non-pharmacological
endovascular thrombectomy
physiotherapy
speech therapy
range of motion exercises
Treadmill training with body weight support
others
psychosocial impact of stroke
to prevent further complications
post stroke depression
anxiety
emotionalism
treated by
counseling
Exercise
Antidepressants
group therapy
Blood supply of the brain
2 arterial systems
Carotid system
aortic arch
left common carotid artery
internal carotid artery
branches
terminal branches
middle cerebral artery
anterior cerebral artery
ophthalmic artery
anterior choroidal artery
external carotid artery
aortic arch
brachiocephalic trunk
Right common carotid artery
internal carotid artery
external carotid artery
Vertebro-Basilar system
aortic arch
subclavian artery
vertebral artery
Anterior spinal artery
posterior spinal artery
medullary branches
PICA (posterior inferior cerebellar artery)
the union of 2 vertebral arteries
basilar artery
branches
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structures determine what functions take place
circle of willis
2 anterior cerebral
2 internal carotid
1 anterior communicating
2 posterior communicating
2 posterior cerebral
Risk factors and causes of stroke
which shows
risk factors of stroke
controllable
diabetes
alcohol
smoking
heart disease
obesity
non-controllable
race
gender
age
genetics
history of strokes
causes of stroke
embolic strokes
commonly affect the MCA
can affect multiple cerebral vascular territories
thrombotic strokes
most common cause of stroke
20% due to large vessel atherosclerosis
global cerebral ischemia
systemic hypoperfusion
hypoglycemia
severe and chronic hypoxia
other causes
vasculitis
arterial dissection
hypercoagulable states
Transient ischemic attack
which can lead to a stroke
is a temporary period of symptoms similar to those of a stroke due to a temporary disruption in the blood supply to part of the brain
often called a mini stroke
signs and symptoms resolves in less than 24h
divided into 3 main mechanisms
lacunar or small penetrating vessel TIA
large artery, low flow TIA
Embolic TIA
pathology and types of stroke
thus it is important to investigate
Cerebrovascular disease
injury to the brain as a consequence of altered blood flow
Ischemic and / or hypoxic
Global
reduction of cerebral perfusion
cardiac arrest
shock
severe hypotension
decreased oxygen carrying capacity of the blood
CO poisoning
anemia
Focal
decrease blood flow to a localized area
hemorrhagic infarct
red infarct
reperfusion
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ischemic infarct
pale infarct
limited
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Hemorrhagic
intraparenchymal
subarachnoid
signs and symptoms resolve in more than 24h