Escolar Documentos
Profissional Documentos
Cultura Documentos
Atherosclerosis
Thrombosis
83
If managed: If not managed
Actual: Possible:
Dx: Dx: PET scan, MRI,
Cranial CT scan (6/16/08) cerebral angiography, Lysed or moved thrombus
Capsuloganglionic bleed lumbar puncture, from the vessel
Lacunar infarct, EEG/ECG, skull x-ray,
Bilateral Internal Carotid carotid ultrasonography
Ateriosclerosis Vascular wall becomes
Doppler (6/16/08) TX: aspirin within 24
weakened and fragile
Mean flow velocities and hrs, thrombolytics
pulsatility index of both within 3 hours, carotid
anterior and posterior stenting, hypothermia,
circulation within normal anticoagulants, surgical Leaking of blood from the
limits decompression fragile vessel wall
(hemicraniectomy),
EEG/ECG, skull x-ray, carotid endartectomy
carotid ultrasonography
Influx of calcium
Further energy
depletion
Release of metalloprotrease
(zinc and calcium-dependent enzymes)
Guarded
Prognosis
Break down of collagen, hyaluronic acid and
other elements of connective tissue
Vascular Congestion
Compression of tissue
Increased intracranial
pressure
Lateral Frontal Lobe Occipital lobe; Branches into Cerebellum and Cerebellum Cerebellum
hemisphere, anterior and ophthalmic, PCA, brain stem
frontal, parietal medial portion of anterior choroidal,
and temporal temporal lobe ACA, MCA
lobes, basal
ganglia
87
Sx: Sx: Sx: Sx:
Sx: Sx: Sx:
Contralateral contralateral Ipsilateral Ataxia,
Contralateral Mild Alternating
hemiparesis or hemiparesis ataxia, facial paralysis of the
hemiparesis, contralateral motor
hemiplegia, with facial paralysis, larynx and soft
foot and leg hemiparesis, weaknesses,
unilateral asymmetry, ipsilateral loss palate,
deficits greater intention ataxic gait,
neglect, altered contralateral of sensation in ipsilateral loss
than the arm, tremor, diffuse dysmetria,
consciousness sensory face, sensation of sensation in
foot drop, gait sensory loss, contralateral
, homonymous alterations, changes on face,
disturbances, pupillary hemisensory
hemianopsia, homonymous trunk and contralateral on
contralateral dysfunction, impairments,
inability to turn hemianopsia, limbs, body,
hemisensory loss of double vision,
eyes toward ipsilateral nystagmus, nystagmus,
alterations, conjugate homonymous
affected side, periods of Horner’s dysarthria,
deviation of gaze, hemianopsia,
vision changes, blindness, syndrome, Horner’s
eyes toward nystagmus, nystagmus,
dyslexia, aphasia if tinnitus, syndrome,
affected side, loss of depth conjugate
dysgraphia, dominant hearing loss hiccups and
expressive perception, gaze,
aphasia, aphasia, cortical hemisphere is paralysis, coughing,
agnosia, confusion, blindness, involved, Mild dysarthria, vertigo, nausea
memory deficits, amnesia, flat homonymous Horner’s memory loss, and vomiting
vomiting affect, apathy, hemianopsia, syndrome, disorientation,
shortened perseveration, carotid bruits drop attacks,
attention span, dyslexia, tinnitus,
loss of mental memory hearing loss,
acuity, apraxia, deficits, visual vertigo,
incontinence hallucinations dysphagia,
coma
88
If managed: If not
Palliative care- managed:
Frequent vital sign and
neurovital signs,
intubation, mechanical
ventilation, Continued insufficiency of blood
vasodilators, osmotic flow
diuretics,
ventriculostomy, ICP
monitoring
Further compression of tissues
Coma
Poor improvement
Cerebral Death
Poor
Prognosis
Loss of neural feedback
mechanisms
Cessation of physiologic
functions
89
Cardiovascular Pulmonary GUT Other systems
GIT
System System
Relaxation of
intestines and Sx: restlessness,
Loss of cardiac Relaxation of abnormal
muscle function sphincters thermoregulation,
venous valves
mental confusion,
increased secretions,
decreased urinary
output.
Sx: Sx:
bradycardi hypotensio
a n Loss of bowel
Failure of accessory Loss of lung control
Decreased muscles for breathing movement
cardiac output Neurogenic bladder Loss of sphincter
control
Sx:
apnea
Cardiopulmonary arrest
Systemic Failure
90
DEATH