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A Case Study Of A Patient With Stroke
Stroke pathophysiology essay
A Case Study Of A Patient With Stroke
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AN ELDERLY MALE WITH NEUROLOGICAL DETERIORATION: A CASE REPORT OF RECURRENT STROKE WITH WORSENING PARKINSON DISEASE.
Ahmad Sahli Mahzuz Bin Ismail
Abstract
Stroke is the third most common cause of death (11% of all death in UK) and the leading cause of adult disability worldwide. Stroke rates increases with age but one quarter of all stroke occur before the age of 65. It is important to differentiate between stroke and transient ischemic attack as its presentation and long term management differ. The condition of stroke will become more severe if there is recurrent episodes of stroke or in association with other comorbidities. The evaluation of stroke should includes the evaluation of classification of Stroke, the initial assessment of patient condition involving the hypothesis based on history,physical examination and confirmation of the diagnosis with brain imaging study. This is a case report of elderly male with
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The differ between those two mainly due to the underlying pathology involving the blood vessel of the brain. Ischemic stroke accounts for about 80 percent of stroke, the pathology involved in this type of stroke maybe intrinsic to the vessel as in thromboembolism, large artery stenosis, small vessel disease and hypoperfusion. Hemorrhagic stroke accounts for about 17 percent of stroke. The pathology involve in this type of stroke is due to the rupture of the vessel that supplying the brain. This condition is more severe than ischemic stroke.
The evaluation of the neurologic symptoms is important in determining acute and long term management for the patient. Basically the evaluation includes the classification of stroke, initial quick evaluation of the patient, and confirming the diagnosis with the investigation. This is a case report of elderly male with recurrent episodes of Stroke with multiple comorbidities.
Case
Mr. Fix-it is a 59 year old man with a history of alcohol abuse and diabetic hypertension. Mr. Fix-it has been currently experiencing symptoms such as: rambling speech, poor short-term memory, weakness on the left side of his body, neglects both visual and auditory stimuli to his left side, difficulty with rapid visual scanning, difficulty with complex visual, perceptual and constructional tasks, unable to recall nonverbal materials, and mild articulatory problems. The diagnosis for Mr. Fix-it’s problem is most likely a right-hemisphere stroke. A right-hemisphere stroke is occurs when a blood clot blocks a vessel in the brain, or when there is a torn vessel bleeding into the brain. “A right-hemisphere stroke is common in adults who have diabetes and who are over the age of 55”, similar to Mr. Fix-it (Kluwer, 2012). In addition, Mr. Fix-it has a history of alcohol abuse in which it could have also increased his chances of experiencing a right-hemisphere stroke.
...th recurrent stroke. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society. 2009;29(2):111-8. Epub 2009/06/06.
It is frequently expressed by stroke patients and caregivers that they have not been afforded the suitable information related to stroke, treatments, or post discharge management and recovery, and that the information conveyed is perceived as insufficient and complex. The problem is that there is a failure of healthcare professionals in identifying the learning needs of stroke patients associated with a deficiency in knowledge of just how to access and communicate this crucial information. Indeed, while patient education can be time consuming and nurses may not be properly trained in stroke education it is a nursing duty to provide these teachings to patients and caregivers prior to discharge. This paper will propose an educational plan intended to train, assist, and support nursing staff responsible for stroke patient education, in providing accurate, individualized, guideline based stroke education to patients and families prior to discharge. This plan
Mr. X is 84 years old. He was admitted to the hospital on January 4, 2014, due to hematuria in his urine and a suspected Transient Ischemic Attack (TIA). After the admission, he was sent for a CT scan, which confirmed Mr. X’s TIA in his right hemisphere. On January 5, 2014 Mr. X was transferred to CP1, an acute care stroke unit. His first TIA episode had been on August 28, 2012. His comorbidities include hypertension and type II diabetes. His activities are limited to bed rest as he has risk of falls; also he is on input-output with a Foley catheter. He has left side weakness and mild facial drooping on the left side. He is alert and oriented; however, he has trouble focusing on many people at one time. His care plan state...
1. What is the difference between a. and a. Introduction The main aim of this report is to present and analyse the disease called Cerebrovascular Accident, popularly known as stroke. This disease affects the cerebrovascular system, which is a part of the cardiovascular system.
Due to the lose in brain cells sometime facial nerve can become damage. Which is also a sign of a stroke. In stroke patient usually when ask to smile, only half of their facial muscle would be able to do so. While the other half remain drooped. The Circulatory system is affect as well. Remember in a Hemorrhagic stroke a ruptured blood vessel begins to bleed out into the brain. Once blood is secreted out side the blood vessel into the tissues, red blood cells will take away nutrient from the brain cells. In Ischemic, the blockage in the blood vessel does not allow the blood to circulated proper. As a result of lost blood supply brain cells will die in the area where it is not receiving nourishment. Traveling in our bloodstream is oxygen and glucose, which is constantly need for cells to preform they daily functions.
Stroke occurs when the blood supply to the brain is blocked or condensed. Blood works to transport oxygen and other beneficial substances to the body’s cells and organs, as well as the brain. There are two main types of strokes that are known as Ischemic strokes and Hemorrhagic strokes. When the blood vessels that provides for the brain becomes congested, is it referred to as ischemic stroke, the most common stroke within adults. Blood clots, a cluster of blood that sticks together, are the cause of Ischemic strokes. Ischemic strokes also takes place when arteries become backed up with plague, leaving less blood to flow. Plague is cholesterol, calcium and fibrous and connective tissue that sticks to the walls of blood vessels. Ischemic strokes eternally damage the brain and cause a person's body to no longer function habitually.Some risk factors that may increase stroke are high cholesterol, diabetes, high blood pressure, and obesity. Some stroke factors are also due to old age or having a family that has a history of strokes. Men are more likely to have a stroke but the most st...
The bleeding of the brain also causes increased pressure on the brain and it presses against the skull. Symptoms of a hemorrhagic stroke vary upon the amount of blood tissues affected and the location of the bleeding. A transient ischemic attack only lasts for a few hours of the day or a day and it doesn't cause permanent brain damage like an ischemic stroke would. (TIA) transient ischemic attack is not considered to be a stroke, it is referred to as a warning signal before having a stroke. Ask yourself how does a stroke change a person's everyday life drastically? People who suffer from strokes have to live with a mental or physical disability that causes them to be limited.
Strokes. Generally, whenever we hear about someone who suffered from a stroke, the result is never good. Why is it that strokes are so dangerous and why is it so important for providers to recognize them as early as possible? What do we do when we suspect a patient is currently having an active CVA (cerebral vascular accident)? All of these are excellent questions that medical providers need to affluent in.
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
“Time is brain” is the repeated catch phrase when addressing the treatment and management of stroke (Saver, 2006). Access to prompt and appropriate medical care during the first few hours of stroke onset is critical to patient survival and outcomes. Recent changes in the guidelines for acute stroke care released by the American Heart Association (AHA) and the American Stroke Association (ASA) have improved patient access to treatment. Stroke treatment now follows the model of myocardial infarction treatment. Hospitals are categorized into four levels based on stroke treatment capability. The most specialized treatment is available in comprehensive stroke centers followed by primary stroke centers, acute stroke-ready hospitals, and community hospitals. The use of telemedicine now enables even community hospitals, with limited specialized capabilities, to care for stroke patients. Telemedicine puts emergency hospital personnel in contact with neurologists providing expertise in the evaluation of a stroke patient and determination of their eligibility for treatment with thrombolytic medication (Jefferey, 2013).
Stroke is a serious medical condition that affects people of all ages specifically older adults. People suffer from a stroke when there is decreased blood flow to the brain. Blood supply decreases due to a blockage or a rupture of a blood vessel which then leads to brain tissues dying. The two types of stroke are ischemic stroke and hemorrhagic stroke. An ischemic stroke is caused by a blood clot blocking the artery that brings oxygenated blood to the brain. On the other hand, a hemorrhagic stroke is when an artery in the brain leaks or ruptures (“About Stroke,” 2013). According to the Centers for Disease Control and Prevention (CDC), “Stroke is the fourth leading cause of death in the United States and is a major cause of adult disability” (“About Stroke,” 2013). Stroke causes a number of disabilities and also leads to decreased mobility in over half of the victims that are 65 and older. The CDC lists several risk factors of stroke such as heredity, age, gender and ethnicity as well as medical conditions such as high blood pressure, high cholesterol, diabetes and excessive weight gain that in...
Stroke is a commonly known disease that is often fatal. This cellular disease occurs when blood flow to the brain is interrupted by either a blood clot halting the progress of blood cells in an artery, called an Ischemic stroke, or a blood vessel in the brain bursting or leaking causing internal bleeding in the brain, called a hemorrhagic stroke. When this happens, brain cells are deprived of oxygen and nutrients because the blood cells carrying these essential things are stopped, causing them to die. When the cells in the brain die, sensation or movement in a limb might be cut off and may limit an organism’s abilities. A person with stroke is affected depending on where in the brain the stroke occurs. In other words, symptoms of a stroke
Paramedics are frequently presented with neurological emergencies in the pre-hospital environment. Neurological emergencies include conditions such as, strokes, head or spinal injuries. To ensure the effective management of neurological emergencies an appropriate and timely neurological assessment is essential. Several factors are associated with the effectiveness and appropriateness of neurological assessments within the pre-hospital setting. Some examples include, variable clinical presentations, difficulty undertaking investigations, and the requirement for rapid management and transportation decisions (Lima & Maranhão-Filho, 2012; Middleton et al., 2012; Minardi & Crocco, 2009; Stocchetti et al., 2004; Yanagawa & Miyawaki, 2012). Through a review of current literature, the applicability and transferability of a neurological assessment within the pre-hospital clinical environment is critiqued. Blumenfeld (2010) describes the neurological assessment as an important analytical tool that evaluates the functionality of an individual’s nervous system. Blumenfeld (2010) dissected and evaluated the neurological assessment into six functional components, mental status, cranial nerves, motor exam, reflexes, co-ordination and gait, and a sensory examination.
The study focused on determining the factors associated with increased morbidity and mortality. We analyzed factors related to higher incidence of complications such as hydrocephalus, elevated intracranial pressure, cerebral Vasospasm, delayed cerebral ischemia and cerebral salt wasting, which may contribute to morbidity and mortality of the disease in our comprehensive stroke center. For each of these components for assessing predictors of morbidity and mortality of SAH, a logistic regression analysis was completed. Complications such as delayed cerebral ischemia and stroke were more frequent in patients with anemia (hemoglobin less than 7) leukocytosis, hyponatremia and with noninfectious fever. In patients with a lower BMI, patients on statins and younger age group, higher re-bleeding rates were seen.