Stroke and its types

Stroke and its types

1. STROKE AND ITS
TYPES
PREPARED BY Dr. Amjad PT

3. What Is Stroke ?
A stroke occurs when blood
flow to the brain is
interrupted by a blocked or
a burst blood vessel.

4. CVA
OSudden loss of neurological function caused by
the interruption of blood flow to brain.
OFocal neurological deficits due to ischemia
OFor classical stroke it must persist for at least 24
hours
OParalysis (Hemiplegia)
OWeakness (Hemiparesis)
OImpairments (reversible) within 3 weeks
OResidual impairment (longer than 3 weeks)

5. What Is the Impact of Stroke?
OStroke is the third leading cause of death in
the United States
OOn average, someone suffers a stroke every
40 seconds
OAbout 795,000 Americans suffer a stroke
each year
OAbout every 4 minutes, someone dies of a
stroke

6. What Is the Impact of Stroke?
(Continued)
OStroke is a leading cause of serious, long
disability
OAbout 6.4 million Americans are stroke
survivors

7. What Are the Types of Stroke ?
OIschemic Stroke (Blockage)
OCaused by a blockage in blood vessels in
brain
OHemorrhagic Stroke (Bleeding)
OCaused by burst or leaking blood vessels in
brain

8. What Are the Causes of
Ischemic Stroke?
OBegins with the development of fatty
deposits lining the blood vessel wall
OThrombus: Development of blood clot at the
fatty deposit
OEmbolus: Traveling particle too large to pass
through a small vessel

9. Embolic Stroke
Blood clot travels to the brain
Thrombotic Stroke
Blood flow is blocked to the brain

10. What Are the Causes of
Hemorrhagic Stroke?
OOccurs when a weakened blood vessel
ruptures
OAneurysms: Ballooning of a weakened
region of a blood vessel
OArteriovenous Malformations (AVMs):
abnormal blood vessels

11. Stroke Risk Factors
That Cannot Be Treated
OAge
OSex
ORace
OPrior stroke
OFamily history

12. Stroke Risk Factors That Can
Be Treated
OHypertension/High Blood Pressure
OHeart Disease
OCigarette Smoking
OTransient Ischemic Attacks
ODiabetes
OElevated Blood Cholesterol/Lipids

13. Stroke Risk Factors
Less Well-Documented
OGeographical Location
OSocioeconomic Factors
OExcessive Alcohol Intake
OCertain Kinds of Drug Abuse

14. Stroke Warning Signs
OSudden weakness or numbness of the face,
arm or leg, especially on one side of the body
OSudden confusion, trouble speaking or
understanding
OSudden trouble seeing in one or both eyes
OSudden trouble walking, dizziness, loss of
balance or coordination
OSudden, severe headaches with no known
cause (for hemorrhagic stroke)

15. ACAS
OContralateral hemiparesis (LE more than UE)
OContralateral hemi sensory loss (LE more
than UE)
OIncontinence
OApraxia

16. MCAS
Contralateral hemiparesis (UE & face more than
LE)
Contralateral Hemi sensory loss (UE & face more
than LE)
Aphasia
Perceptual deficits

17. PCAS
•Contralateral homonymous hemianopsia
•Memory defect
•Hemiplegia
•Eye movements

18. Transient Ischemic Attacks
(TIAs)
O“Warning strokes” that can happen before a
major stroke
OOccur when blood flow through a brain
artery is blocked or reduced for a short time
OSymptoms are temporary but similar to
those of a full fledged stroke
OA person who has a TIA is 9.5 times more
likely to have a stroke

19. What Parts of the Brain
Are Affected by Stroke?
OLEG
OARM
OBODY
OHAND
OFACE
OSPEECH
OREADING
OSIGHT
OHEARING

20. What Are the
Effects of Stroke?
OParalyzed left sight
OSpatial perceptual
defects
OQuick impulsive
behavioral style
OMemory deficits
ORight Brain

21. What Are the
Effects of Stroke?
OParalyzed right side
Ospeech-language
deficits
OSlow cautious
behavioral style
OMemory deficits
OLeft Brain

22. Motor deficits
OEarly stages flaccidity, no voluntry movement
and no reflexes
OCerebral shock lasts from 72 hours to 2 weeks
(can be longer)
OThis is replaced by spasticity, hyperreflexia and
mass pattern (synergies)
OBobath divided stroke into 3 stages
O1-The initial flaccid stages
O2-The stage of spasticity
O3-The stage of relative recovery

23. How Are Strokes Treated?
OIschemic Stroke
O• Clot-busters e.g., t-PA
O• Anticoagulants –warfarin
O• Carotid Endarterectomy
O• Angioplasty/Stents
OHemorrhagic Stroke
O• Surgical Intervention
O• Endovascular Procedures, e.g., coils

24. Prevention of Stroke
OControl high blood pressure
OPrevent heart disease
OStop cigarette smoking
ORecognize signs of TIA and tell physician
OReduce blood cholesterol levels

25. Twitchell and Brunstrom
divided into 6 stages
Stage 1periods of flaccidity , no movements
Stage 2limb synergy ,minimal voluntary movement,
spasticity starts
Stage 3control of synergy movement, spasticity
becomes severe
Stage 4some movements without synergy happens,
spasticity decline
Stage 5difficult movement pattern develops, spasticity
decreases
Stage 6disappearance of spasticity, individual joint
movement possible, coordination, normal motor
function restored.
this stage is not for all patients

26. Rehabilitation
OAfter suffering a stroke,
it’s important to begin a
rehabilitation program
as soon as possible

27. Types of Rehabilitation
Programs
OHospital programs
ONursing facilities
OOutpatient programs
OHome-based programs

28. Rehabilitation Specialists
OPhysician
ORehabilitation nurse
OPhysical therapist
OSpeech therapist
OOccupational therapist
OPsychiatrist

29. Learn to recognize a stroke.
Time lost is brain lost.
Stroke is a medical emergency!
If you notice one or more stroke warning
signs,
GET HELP IMMEDIATELY