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Neuro/Cognition: Ischemic Stroke (thrombotic) - Coggle Diagram
Neuro/Cognition: Ischemic Stroke (thrombotic)
Etiology/Pathogenesis
Caused by a thrombus
Thrombus partially or fully occludes cerebral blood flow to an area of the brain (usually the cortex) → cellular metabolism stops → cell membrane and depolarization are affected and Na+/K+ pump fails → edema occurs as Na+ draws H2O into the cell → neurons die from prolonged hypoxia
Manifestations
Change in LOC
Facial droop
Specific to affecting the cortex= aphasia, visual defects, hemineglect
Sensory losses
Hemiparesis or hemiplegia
Complications
VTE
Bleeding complication r/t fibrinolytic tx (ICH)
Cerebral edema
Aspiration pneumonia
Motor deficits
Dysarthria and aphasia
Hemineglect
WORST= death
Labs/Diagnostics
Coagulation studies
ABCs
CT scan
MRI
Cerebral angiography
Collaborative Treatments
Fibrinolytic treatment
Mannitol to reduce ICP
Supplemental O2
Swallow assessment, possible NPO
ROM exercises
Provide appropriate means of communication
Frequently monitor VS and neuro checks
Catheter directed mechanical clot disruption
Risk Factors
HTN
Smoking
Obesity
High cholesterol
DM
A-fib
Cocaine use
Heavy alcohol use
Age
Sex gene
African American race
Heredity/family hx
TIA