Case Presentation

OF

Ischemic Stroke
BY

Dr. Mohammed Afroz Roll No: 176311989032 Adv Dip in Emergency Medical Care Guided By Dr Md. Samiullah Khan(Director Academics) Medwin Institute Of Medical Sciences

Ischemic Stroke

Definition of Ischemic Stroke

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain

function due to disturbance in the blood supply to the brain. This can be
due to ischemia (lack of blood flow) caused by blockage thrombosis, arterial embolism), or a hemorrhage. As a result, the affected area of the

brain cannot function, which might result in an inability to move one or

more limbs on one side of the body, inability to understand or formulate speech, or an inability to see one side of the visual field,

Signs and symptoms

Abrupt onset of hemiparesis, monoparesis, or quadriparesis Acute hemisensory loss Complete or partial hemianopia, monocular or binocular visual loss, or diplopia Visual field deficits Diplopia Dysarthria Ataxia Vertigo Nystagmus Aphasia Sudden decrease in the level of consciousness

Causes of Ischemic stroke

The build up of fatty material (atheroma) along the walls of an artery, which reduces blood flow Breaking off of atheroma from the artery wall. The material can flow with the blood and become stuck in a smaller artery, causing a blockage. Drugs, such as cocaine and amphetamines, which can also narrow the blood vessels Inflammation or an infection that narrows blood vessels that lead to the brain A sudden drop in blood pressure. Although a sudden drop in blood pressure usually causes a person to faint, it can lead to a stroke if it is severe and prolonged. This can occur when someone loses a lot of blood from an injury or during surgery, has a heart attack or has an abnormal heart rate or rhythm.

Diagnosis
With the availability of thrombolytic therapy for acute ischemic stroke in selected patients, the physician must be able to perform a brief, but accurate, neurologic examination on patients with suspected stroke syndromes. Essential components of the neurologic examination include evaluations of the following: MRI Scans Doppler Ultra Sound Arteriogrphy Cerebellar function, Gait Deep tendon reflexes level of consciousness

Management
Thrombolysis with recombinant tissue plasminogen activator (rtPA)

Mechanical thrombectomy Hemicraniectomy Platelet antiaggregants Antihypertensives HMG-CoA reductase inhibitors (statins) Lifestyle interventions

Epidemiology
More than 700,000 persons per year suffer a first-time stroke in the United States, with 20% of these individuals dying within the first year after the stroke. If current trends continue, this number is projected to reach 1 million per year by the year 2050.[34] Stroke incidence by race and sex In the United States, blacks have an age-adjusted risk of death from stroke that is 1.49 times that of whites.[35] Men are at higher risk for stroke than women; white males have a stroke incidence of 62.8 per 100,000, with death being the final outcome in 26.3% of cases, while women have a stroke incidence of 59 per 100,000 and a death rate of 39.2%. Stroke and age Although stroke often is considered a disease of elderly persons, one third of strokes occur in persons younger than 65 years.[34] Risk of stroke increases with age, especially in patients older than 64 years, in whom 75% of all strokes occur.

Thank You