Acute Stroke

Neuroradiological imaging plays an important role in the process of diagnosing ischaemic stroke. The different imaging modalities that can be used to diagnose ischaemic stroke include computed tomography (CT), magnetic imaging resonance (MRI), and radionuclide imaging. In this article, the different modalities that contribute to the diagnostic process are discussed, with a focus on CT scan protocols.

Given the absence of a clinical test to accurately distinguish between haemorrhagic and ischaemic strokes, imaging at this early stage is vital. A non-contrast CT brain is often performed at this point although when unavailable, MRI is usually more sensitive and specific in identifying stroke lesions at the cost of longer examination times (Vymazal, Rulseh, Keller & Janouskova, 2012).

The diagnostic process for a formally diagnosing Cerebral Vascular Accident (CVA/stroke), would consist with a number of test including a physical exam and questions regarding your family history of strokes, any signs or symptoms that may have been present before the patient had the stroke. The physician would also order a few tests like a MRI, CT scan, Cerebral Carotid ultrasound, Cerebral Angiogram and an Echo Cardiogram. The physical exam is important to listen to the hearts sounds, take your blood pressure and also use a ophthalmoscope ( a scope to look in your eyes, ears and nose) to see if there are any cholesterol crystals behind the eyes("Diagnosis - Stroke - Mayo Clinic," 2015). A MRI, uses radio and magnetic waves to show a detailed

There are three types of strokes that cause changes to the brain: Hemorrhagic stroke,Intracerebral hemorrhage and Transient ischemic attack (TIA). Ischemic stroke is the most common form of stroke, accounting for around 87% of strokes.

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.

Stroke previously known as Cerebrovascular accident is well-defined as ‘an abrupt cessation of cerebral circulation in one or more of the blood vessels distributing the brain. Due to the interruption or diminish of oxygen supply causes serious damage or necrosis in the brain tissues (Jauch, Kissella & Stettler, 2005). There is a presence of one or more symptoms such as weakness or numbness or paralysis of the face, arm or leg, difficulty speaking or swallowing, dizziness, loss of balance, loss of vision, sudden blurring or decreased vision in one or both eyes and headache. Stoke is categorised into two types, Ischaemic and haemorrhagic

When trying to detect the onset of a stroke, remembering the acronym F.A.S.T. is important (Face drooping, Arm weakness, Speech difficulty, Time to call 911). If stroke symptoms are detected within an individual, they have just a couple hours before it is too late for any preventative treatment options. Unfortunately, the type of stroke cannot be identified except through several tests (physical test, blood test, CT, MRI), which are important because treatments are different for the different types of strokes. It would be hazardous to administer the wrong stroke treatment to an individual having a different kind of stroke. (McIntosh) Seeing the precursors to a stroke and preventing it is not always possible; therefore, the stroke victim may have some damaging effects on their body. Strokes can affect a body in different ways depending on which side the blood clot occurs. If the blood clot occurs in the right side of the brain, the left side of the body and the face will be affected. In addition to paralysis of the body and face, vision problems, memory loss, and quick, inquisitive behavior could result from a blood clot on the right half of the brain. If the clot were to occur in the left side, the right side of the body would suffer speech and language problems, slow behavior, or memory loss. (About Stroke.) Aside from the physical effects of a stroke, a victim might also be affected emotionally undergoing depression, or being unable to control their feelings. (McIntosh) Oftentimes, the outcome of a stroke is irreversible and saddening for everyone

This tool is applied to the assigned CPG "Clinical guidelines for stroke management 2010" in relation to the management, diagnosis and treatment of stroke. Stroke occurs when there are blood clots

     If doctors agree that a stroke has taken place, they may do other tests to determine where the stroke occurred, how large of an area is damaged, and how the blood flow with in the brain has been effected; they do this by taking a CAT scan. They may also take an ECG to determine if there is any heart disease that may have caused the stroke. In addition, they take tests to see if the patient has high blood pressure or they may test the arteries themselves because this is a major cause of stroke in most people. Catheterization, injecting dye into the arteries, and blood tests are the most common tests done. A high glucose level in the blood may reveal diabetes and high blood fats indicate thickened red blood and arteriosclerosis. There may also be a high level of red blood cells, changing the consistency of the blood. These conditions must be treated to prevent further strokes.

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.

The next step is to do tests on the brain itself to rule out other possible conditions. Doctors will often do a CT scan first, then an MRI, and possibly a PET scan; these tests will show abnormalities of the brain, and they will help rule out tumors, clots, or if the patient has had a stroke.

“Thrombectomy for anterior circulation stroke due to proven proximal major vessel (carotid or M1) occlusion within 6 hours of stroke onset is safe and highly effective and sets the new standard of

The stroke from a blocked artery is called ischemia, and the ruptured artery is hemorrhagic. As time is critical after the cerebrovascular accident, lack of treatment will lead to brain cell apoptosis and neural injuries are permanent. Evaluation using brief tests of cognitive impairment includes analysis of executive functioning, memory, language, and visuospatial performance, neuropsychiatric as well as depressive symptoms (Grant and Adams, 2009).

1. Every 40 seconds someone in the United States has a stroke (National Stroke Association, 2014). Some symptoms related with a stroke are headache, blurred vision, trouble speaking, confusion, dizziness and numbness on one side of body. These symptoms are very important to know. Due to how common strokes are it's good to know the warning signs. For every person that dies from stroke, more than 5 times that many will survive, and for them the physical damage it causes can be enormous (National Stroke Association, 2014). Most people who have a stroke are depressed after it's all said and done. They may be paralyzed on one side, have a speech impairment or worse. When you are used to living a certain way and that suddenly changes it can be hard for people to deal with.

I) Describe what would happen if there was a thrombosis (clot) in the middle cerebral artery?