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Ali Javed Case

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Definition, S/Sx, Treatment, Citation(s): A CVA is the interruption of blood flow in one or more of the blood vessels that supply the brain. Stroke is the leading cause long-term disability and the third highes cause of death in the United States (Elmore & Miller, 2005). Tissues become ischemic, leading to hypoxia or anoxia with destruction or necrosis of the neurons, glia, and vasculature (Sommers & Johnson, 2002). There are two types of strokes, embolism (ischemic) and hemorrhagic. Early signs of an impending ischemic stroke are transient hemiparesis, hemiosensory loss, and loss of speech. A hemorrhagic stroke occurs very rapidly, with symptoms developing in minutes to hours. Symptoms of hemorrhagic strokes include occipital or nuchal headaches, vertigo or syncope, epistaxis, retinal hemorrhages, parethesias, and transient paralysis. Also, symptoms must persist longer than 24 hours to be diagnostic of a stroke (Minton, 2005). "If certain conditions are met, IV-t-PA can be administered within three hours of a stroke to reduce chances of death and disability" (Elmore & Miller, 2005, p.58). Medical management of a CVA includes support of vital functions and ongoing surveillance to identify early neurologic changes as the patient's condition evolves. Treatment consists of maintaining life, reducing ICP, preventing complications, and limiting the extension of the CVA. For patients that cannot maintain their own airway and circulation independently, ventilation, intubation, and oxygen may be required. If the CVA is hemorrhagic, surgery may be needed to stop the bleeding or remove the hematoma. Also, physical therapy is very important and should begin as soon as the patient's condition stabilizes. One should use passive range of motion exercise to prevent the development of contractures on the affected side. Lastly, strengthening the unaffected side is important because it helps to compensate for the losses on the affected side (2002).



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