PCA Embolism

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.

An ischemic stroke is typically caused by a thrombosis, which is a blood clot or an embolism, when the blood clot detaches and infiltrates the blood stream.

Also, a cardiac ECHO with Definity study was scheduled for 5/22/17 to reevaluate the LV thrombus, pending which a decision for anticoagulation was to be made. Inpatient Neurology evaluated him on 5/20/17, and also mentioned in their consult note that the patient had an acute CVA in April 2017, and recommended continuation of ASA and Plavix, along with considering initiating statins, and that MRI brain can be done after 6 weeks of stent placement if there were no contraindications (Although per the Neurologist’s note – the patient informed that he had PTCA 1 month ago, while in reality, his stent was placed in 3/2017; and a MRI of the brain was never subsequently done during this admission).

The health issue that this artifact discusses is the significance of knowing and recognizing the warning signs of a stroke. The American Heart Association has made it their mission to provide unlimited health information and research in the hopes of eliminating cardiovascular diseases as well as helping society in maintaining a healthy lifestyle. “Stroke is the number 5 cause of death and a leading cause of

My name is Shankar Pattabhiraman, and I am an incoming senior at New Albany High School. I will be graduating in June of 2016, and I am thinking of pursuing a chemical or biomedical engineering major in college, or possibly biochemistry or neuroscience. My career goal is to become a physician, or perhaps a physician scientist. I am especially interested in neurology-related fields, and this interest has been reinforced in several ways: participating in the 2015 National Brain Bee Championships competition in Baltimore, MD, volunteering at Riverside Methodist Hospital in the Neurocritical Care Unit and the Stroke and Brain Center, and helping Tony Hall and his friends who suffer from neurological disorders and diseases. I chose to study ischemic strokes because I am interested in neuropathology, both clinically and through research. In addition, through my volunteering at RMH, I have worked with patients who have suffered from strokes, and while the symptoms’ onset is sudden, the events leading up to the stroke are long-term but rarely treatable.

When an artery in the brain is block (ie; TIA) open collateral vessels can allow blood to

Cerebrovascular accidents, or strokes, will lead to brain damage that affects the functioning of executive function, memory, language, visuospatial performance and emotional states. Corresponding vertebral arteries and carotid arteries provide blood to the brain from the heart that the carotid arteries are internal and external sections of the thyroid cartilage. Where the optic nerve rests the internal artery distributes into the anterior and middle cerebral arteries. The vertebral arteries arise through the spinal vertebrae and meet the lower pons to form the basilar artery. The brain receives 15% to 20% of the oxygenated blood from the heart and can only endure fleeting interruptions of blood flow before neural operations

A blockage in the blood vessels that carry blood to the back of the brain (vertebrobasilar arteries).

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

A Deep Venous Thrombosis (DVT) will propagate when there is either stasis of blood flow, endothelial injury, or if the patient is in a hypercoagulable state. Under physiological conditions, a dislodged DVT can predictably settle in the pulmonary arteries causing a pulmonary embolism. However, a DVT in the presence of a intracardiac shunt or PAVM can paradoxically cause an embolism in branches of the aorta. The pathophysiological mechanism varies depending on the etiology of the paradoxical embolism. For instance, in a paradoxical embolism due to a PFO, a DVT gets dislodged and enters the right atrium where a transient increase in right atrial pressure during a Valsalva maneuver can force the embolism through the PFO and into the left atrium

This stagnant blood forms clots that break off and inter the circulation. Atrial Fibrillation is a factor in about 15% of Embolism stroke.The risk of a stroke from atrial fibrillation can be dramatically reduced with daily use of anticoagulant medication.

This type of PCA stroke is ischemic, and not cause by a hemorrhage. The emboli that are located within the artery cause edema, causing pressure on the brain. Thrombolytic and antithrombotic agents can be used in the treatment of ischemic strokes. For the emergent care of PCA stroke, rt-PA can be used. T-PA activates plasminogen to form plasmin. The plasmin has the ability to digest fibrin strains of emboli; removing the blood blot that is interrupting blood flow to the brain. After t-PA is given the patient's blood pressure will be monitored and kept at less than 180/105 mm Hg. Antithrombotics agents should not be given for 24 hours after t-PA administration.

A stroke caused by a blocked artery by a blood clot or bursting of a blood vessel because of uncontrolled high blood pressure. There are main three types of the stroke. An ischemic stroke occurs when a blood clot blocks one of the arteries which supply blood to brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions. (mayo clinic). About 89%, strokes are ischemic strokes. Ischemic stroke includes thrombotic stroke. A thrombotic stroke occurs when a thrombus stuck in one of the arteries that supply blood to the brain. A clot build-up of fatty deposits in arteries. Another type of stroke is called the hemorrhagic stroke. This stroke occurs when a blood vessel leaks or ruptures in the brain. A bold vessel leaks or ruptures from many conditions like uncontrolled high blood pressure or overtreatment with anticoagulants and the weak spot in blood vessel walls. (mayo). Some people experience a mini-stroke it is known as a transient ischemic attack (TIA). A temporary decrease or clot stuck in a vessel in our brain causes TIA. It happens less than five minutes. This stroke does not have any symptom, because the blockage is

Angina pectoris and cerebrovascular accident share common risk factors, which, according to the American Heart Association are, smoking, a sedentary lifestyle, poor nutrition, overweight and /or obesity, high blood pressure, high cholesterol and diabetes (Benjamin et al., 2017). The symptoms of a heart attack happen when a the blockage and narrowing of the coronary artery causes the heart muscles to work harder and ultimately fails to pump the blood supply