Acute Ischemic Stroke: A Case Study

Strokes are caused by a block in the blood supply to the brain which causes a decrease in oxygen and delivery of other important supplies which facilitate proper functioning. Fifteen million cases are reported worldwide annually, although not all of these cases are mortalities, the large prevalence of strokes ranks it as the fourth leading cause of death in the United States. (Figueroa) Because of the time sensitivity associated with the lack of resources to the brain, strokes are considered a medical emergency and early recognition of symptoms can help decrease the amount of damage caused . Although strokes do not always cause death, strokes most often leave the individual with some physical and cognitive impairment.

Mariam background is 60 year old lady admitted with left sided weakness and facial droop. Once confirmed stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale. Catangui (2015) states ROSIER scale is used to distinguish whether the patient is having a stroke or stroke mimics e.g. seizures or brain tumours. Computed tomography CT brain showed ischemic stroke. Ischaemic stroke is lack of sufficient blood supply to perfuse the brain/ cerebral tissue due to narrowing or blocked arteries in the brain (Morrison, 2014). According to Stroke Association (2015) statics shows that 1520000 strokes occur in the United Kingdom.

Aneesh Singhal, MD, author of Recognition and management of stroke in young adults and adolescents, from the Clinical Journal of the American Academy of Neurology states

It is important that the type of stroke is diagnosed quickly to reduce the damage done to the brain and also to determine the right type of treatment because one treatment for one kind of stroke can be harmful to someone who has had a different kind. A number of different medications may be given at the hospital to help break up the clot and prevent the formation of new clots. For Ischemic stroke the treatment can begin with drugs to break down clots and prevent further ones from forming. Aspirin can be given, along with an injection of a tissue plasminogen activator (TPA). TPA works by dissolving clots but it needs to be injected within 4.5 hours of stroke symptoms once they have presented themselves. Hemorrhagic stroke treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels.(http://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/treatment/txc-20117296) Because strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke,

Strokes are caused by pathophysiological changes. The two major mechanisms of stroke consist of ischemia and haemorrhage. Ischemia is when there is no oxygen or not, merely enough oxygen to fuel the tissue level in the body. Haemorrhage in the brain, causing strokes can be due to non-traumatic intracerebral haemorrhage (Shah, MD, n.d.) (see appendix 1). This essay will further discuss the implications of strokes on a cellular, organ and system level. Explain the clinical presentation of the signs and symptoms of strokes and how the condition will be managed by a paramedic.

Stroke, or brain attack, is the number four killer of adults in the world. In the United States, 160,000 deaths occur each year. From 1999 to 2009, the death rate from stroke gradually lowered as improvements to medicine and testing developed. Yet, 800,000 Americans continue to have strokes and survive the event. Worldwide, about 15 million experience stroke with 6 million who die and 5 million who become permanently disabled. (Robinson, Richard & Odle, Teresa G. & Frey, Rebecca J. & Odle, Teresa G. , 2011) The statistics in America are better for surviving a stroke because of rapid response and better interpretation of symptoms. Nevertheless, surviving a stroke often brings on dilapidating effects; which means a change in lifestyle and lifelong rehabilitation through physical therapy.

According to Centers for Disease Control and Prevention, it is stated that “every 40 seconds, someone in the U.S. has a stroke” (“Stroke,” 2018). Cardiovascular disease (CVD) is the leading cause of death for both men and women in the United States, which include coronary heart disease, stroke, and other related conditions. There are various modifiable and non-modifiable risk factors associated with heart disease, such as age, family history, diet, physical inactivity, high blood pressure, and more (“2016 Community Health Assessment,” 2017). About 795,000 people suffer from stroke each year and it is more common among the elderly, ages 65 years and older, in the United States (“Stroke,” 2018). The consequences of stroke can be detrimental,

Going to the hospital as soon as signs or symptoms is notice is the key to stroke treatment (CDC, 2017). Tissue plasminogen activator (TPA) can be used for ischemic stroke if arrival to the hospital is within three hours of the first symptoms. Medicine, surgery, and rehabilitation can also be used for treatment of stroke (CDC, 2017).

The third leading cause of death and leading cause of disability in American adults is a stroke. It is a medical emergency with an individual affected every 45 seconds in America. It occurs when there is an obstruction of blood flow caused by a ruptured blood vessel or blood clot resulting in depletions of oxygen supply to the brain. It results in a wide range of devastating effects depending on the affected brain part such as loss of speech, loss of thought process, loss of activities of daily living (ADL), or death. A stroke lasting for a few minutes is known as a Transient Ischemic Attach (TIA) or mini-stroke and if ignored can result in disability (Stroke, 2016). The American Heart Association (AHA), American Stroke Association (ASA), & Brain Attack Coalition (BAC) developed eight core measures for stroke (STK). These measures were approved by The Joint Commission (TJC) in 2009 for hospitals to become certified as a primary or comprehensive stroke center. The measures include Venous Thromboembolism (VTE) Prophylaxis; Discharged on Antithrombotic Therapy; Anticoagulation Therapy for

As stated in Acute Stroke Intervention (Prabhakaran, Ruff, & Bernstein, 2015), one of the leading causes of death and disability in the United States are strokes. Acute ischemic stroke (AIS) results when an artery that is supplying the brain becomes blocked, this occurrence leads to cell death of brain tissue. Improving brain function after an ischemic stroke is of high priority for clinical research. General consensus shows that administration of intravenous recombinant tissue plasminogen activator (IV rtPA) therapy is helpful when introduced within 4.5 hours of ischemic stroke symptom onset. The benefit of intravenous (IV rtPA) lessens when the onset of symptoms goes beyond 4.5 hours. The use of (IV rtPA) is contraindicated when there is

Mr X, a 60 year- old Caucasian male, admitted to the stroke unit with a diagnosis Left MCA infract. He presented to the emergency department right sided hemiparesis, neglect of affected limbs, dysphasia and right side facial droop. He was on cardiac monitor for close observation for 48 hours. Stroke critical care pathway and commenced and care provided as per protocol.. Stroke is a serious and deadly condition including cerebral circulation within the brain and can extremely affect a person ability to maintain a safe environment, communication and mobility as well as other activities of living. The purpose of this essay is to give an overview of the Pathophysiology of ischaemic stroke, the required nursing care and the rationale behind it, followed by medical management and treatment provided to the patient.

thrombotic stroke (doc1.pdf-[38] ). New evidence revealed that treatment with statin prior to the occurrence of severe ischemic stroke is effective in providing a better neurologic presentation and lower death rate yet a non-favorable effect of statin is an increased incidence of brain hemorrhage (doc2.pdf-[conclusion]).

The article emphasizes time as a critical aspect to acute ischemic stroke management. The leading method of treatment in AIS is intravenous rtPA because the door-to-needle time is less compared to the time it takes to do methods that use thrombectomy devices or catheterization. I believe that it is vital for people to know the signs and symptoms of acute ischemic stroke because it is one of the leading causes of death and disability. The faster one is able to identify these signs and symptoms, the better an outcome it would be for both the patient and their family members. The general public and hospital staff members should be educated on AIS. This article also briefly touches on the fact that patients suspected of having a more severe stroke (proximal artery occlusion) should be immediately transported to a

The stroke is a condition with an abrupt onset of a neurological deficit that attributable to a focal vascular cause. (1) It is the third leading cause of death worldwide. (2) Lower-income countries have shown a higher relative stroke burden compared to industrialized ones. (3) Despite the significant achievement in management of acute stroke, it remains also a third cause of death in industrialized countries.(4) Over a third of stroke deaths occur in developing countries(5) In the United States,700000 stroke cases responsible for 165000 deaths each year (6). The number of people having a stroke each year in Iraq is around 24000. (7) Determining predictor of mortality at period of hospitalization could aid a clinical care by providing valuable prognostic information to patients and their family members and identify those at high risk for poor outcomes who may require more intensive recourses. Various clinical variables have been implicated in the etiology of in hospital mortality of stroke. This study is an attempt to evaluate the effect of a number of these variables and whether they could predict in hospital mortality or not. These predictors included important co- morbidities like diabetes mellitus ( DM), ischemic heart diseases(IHD) hypertension( HTN) , and role of diastolic blood pressure (DBP) in first few hours after attack , history of old stroke and medications that expected to change the outcome of

Thrombolytic medications are approved for the immediate treatment of stroke and heart attack. The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA), but other drugs can do the same thing.