Stroke Seizure: A Case Study

     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.

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

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

Ischemic stroke is the blockage of blood vessels in the brain as a result of blood clots (thrombi), causing the portions of the brain nourished by the vessel and its tributaries to be starved of nutrients, poisoned, and to eventually die (“Symptoms

To have their symptoms diagnosed, a person must first seek medical treatment. Only 20-25% of patients who are admitted to the hospital with a stroke arrive in the emergency department within 3 hours of the onset of symptoms (3). Once a doctor is able to determine what kind of stroke has occurred, it is important the appropriate medicine be given. If the wrong medicine were given to treat a stroke victim, it could result in death. Treatment for an ischemic stroke will focus mainly on restoring blood flow

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,

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.

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

The initial signs of acute stroke on nonenhanced CT are subtle but signs that may be visible would include: loss of distinction between white and grey mater, hypodensities in the brain parenchyma, loss of appearance of sulcal markings on surface of the brain and obscured delineation of basel ganglia. The presence of hyerdensity in a main artery may imply thrombus in a main cerebral artery. In the absence of contrast this sign has a high specificity but a low sensitivity for middle cerebral artery occlusion. Overall a nonenhanced CT brain in acute stroke has a sensitivity as low as 26%.

These findings most likely to lead to the correct identification of a case of stroke increasing the likelihood when at least one of these is present.  While these findings are not perfect for diagnosing stroke, the fact that they can be evaluated relatively rapidly and easily make them very valuable in the acute setting.

Perfusion CT Imaging of Brain is a quick and convenient method of assessing perfusion disturbances in acute stroke patients. Three-color image maps with quantitative results related to patient regional cerebral blood volume (rCBV), mean transit time (MRTT) and regional cerebral blood flow (rCBF) are generated that displays stroke much earlier than the conventional CT images. Areas of less severe CBF reduction, with preserved CBV value represent “ischemic penumbra”, a term describing tissue at high risk for infarction but not yet irreversibly infracted. The larger the ischemic penumbra relative to the core, the more likely the patient would benefit from early thrombolytic therapy. If both CBV and CBF are already reduced dramatically, the

A fifteen minute window during a stroke can determine the degree of debilitation for the client, so making care available faster is a key component. An estimated 800,000 Americans suffer from a stroke each year, that’s one every 40 seconds. A stroke patient receives the only FDA-approved treatment for an ischemic stroke, which is the most prevalent kind, but first to even receive that medication, the stroke must be confirmed by a CT scan. The medication is a clot-buster called tissue plasminogen activator or tPA, and it must be administered within 2 hours of the signs of stroke to be most effective, but that doesn’t always happen in that window due to the time it takes to get care. On average, patients received a CT scan more than 20 minutes faster when using the mobile stroke unit rather than in the radiology unit of a hospital. They also noted a "significant reduction" in treatment time, 64 minutes when the mobile unit responded versus 104 minutes in the emergency room. With a CT machine in the ambulance that test can be rendered, so by the time they arrive at the hospital, the correct patient care can already be

A cerebrovascular accident more commonly known as a stroke or brain attack is the term used to describe the sudden death of brain cells in a localized area due to inadequate blood flow. In order to woke the brain needs a constant supply of oxygen and nutrients. This supply is carried to the brain

To diagnose the exact stroke type the clinician should have good knowledge of neuro anatomy, vascular anatomy of central nervous system, The cellular and metabolic changes of brain can be diagnosed with radiographic to identify the lesion, hemorrhage, size, extent and severity of vascular lesion by computed tomography (CT), magnetic resonance imaging (MRI) and Doppler ultrasound to check the blood flow (Goodman, & Fuller, 2015). Laboratory and diagnostic test are performed by urinalysis; blood analysis to check complete blood count, platelet count, prothrombin time, thromboplastin time, and erythrocyte sedimentation rate; fasting blood glucose levels; blood cholesterol and lipid profile levels; cardiac evaluation to check electrocardiograph;