Behavioral Objectives To make the student define the stroke. To make the student learn the types of stroke. To make the student Know who are the people at risk. To make the student understand the Pathogenesis of stroke. To make the student know how to diagnose stroke. To make the student know how to differentiate stroke from other causes of focal neurological deficit. To make the student Know the treatment of stroke.
Listen to this case : Ali Ahmed is 65 years old teacher with history of HTN,DM. Sudden onset headache followed by weakness of upper and lower limbs in the right side. At ER,neurological examination shows normal consciousness and cognitive function with right hemiparesis. ECG and lab. Investigation were normal Brain CT scan show hypointensity left hemisphere. What is differential diagnosis? What is the diagnosis?
Definition Stroke is a syndrome characterized by the acute onset of a neurologic deficit that persists for at least 24 hours, reflects focal involvement of the CNS, and is the result of a disturbance of the cerebral circulation.
Types Stroke results from either of two types of cerebral vascular disturbance: 1. Ischemia : Thrombotic Embolic 2. Hemorrhage
Epidemiology Stroke is the third most common cause of death in the United States The most common disabling neurologic disorder. About new strokes occur and about people die from stroke in the United States each year. Age Gender Race
Risk factors for stroke Systolic or diastolic hypertension Hypercholesterolemia, Cigarette smoking, diabetes, Heavy alcohol consumption, Oral contraceptive use. Diabetes mellitus genetic
pathogenesis
Diagnosis
Diagnosis: 1-CLINICAL FINDINGS A. HISTORY 1. Predisposing factors 2. Onset and course PHYSICAL EXAMINATION 1. General physical examination 2. Neurologic examination 2-INVESTIGATIVE STUDIES
Differential diagnosis Vascular disorders Other structural brain lesions Metabolic disturbances
Treatment:
Treatment General treatment: Specific treatment: Acute treatment preventive treatment