2. 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.

3.  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?

4. 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.

6. Types  Stroke results from either of two types of cerebral vascular disturbance: 1. Ischemia :  Thrombotic  Embolic 2. Hemorrhage

8. Epidemiology  Stroke is the third most common cause of death in the United States  The most common disabling neurologic disorder.  About 750 000 new strokes occur and about 150 000 people die from stroke in the United States each year.  Age  Gender  Race

9. Risk factors for stroke  Systolic or diastolic hypertension  Hypercholesterolemia,  Cigarette smoking, diabetes,  Heavy alcohol consumption,  Oral contraceptive use.  Diabetes mellitus  genetic

10. pathogenesis

11. Diagnosis

12. 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

13. Differential diagnosis  Vascular disorders  Other structural brain lesions  Metabolic disturbances

14. Treatment:

15. Treatment  General treatment:  Specific treatment:  Acute treatment  preventive treatment