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Aschemic Stroke Research Paper

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Aschemic Stroke Research Paper
STROKE or CEREBROVASCULAR ACCIDENT (CVA)

Definition ← is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain

Epidemiology ← Stroke is currently the second leading cause of death in the Western world, ranking after heart disease and before cancer ← The incidence of stroke increases exponentially from 30 years of age, and etiology varies by age ← 95% of strokes occur in people age 45 and older, and two-thirds of strokes occur in those over the age of 65. ← Stroke kills more than 160,000 American each year ← Men are 25% more likely to suffer strokes than women.

Risk Factors Modifiable ← Hypertension ← Diabetes ← Cardiac
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Swelling, pain, warm skin, tenderness, redness (particularly at the back of the leg, below the knee)

Pharmacological Management o tPA: The most preferred IV tPA agent is alteplase. It has been approved by FDA for its efficacy in treating ischemic stroke. o Antiplatelets Agents: The most authentic drug for the treatment of ischemic stroke is aspirin. Within 24 to 48 hours of stroke aspirin therapy should begin. Ticlopidine is known to produce aspirin- like effects. o Oral warfarin and infusions of heparin can also be given. o Osmotic agents such as intravenous mannitol 20% and potent sterods like dexamethasone 4 mg intravenous is given to control cerebral oedema. o Blood Pressure medication (Angiotensin II receptor blockers (ARBS), Angiotensin-converting enzyme (ACE) inhibitors, Beta-blockers, Calcium channel blockers, Diuretics.

Medical/Surgical Management • Carotid endarterectomy Carotid endarterectomy is a procedure used to remove plaque and clots from the carotid arteries, located in the neck. These arteries supply the brain with blood from the heart. Endarterectomy may help prevent a stroke from occurring. • Carotid
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• Surgery to repair aneurysms and arteriovenous malformations (AVMs) An aneurysm is a weakened, ballooned area on an artery wall that has a risk for rupturing and bleeding into the brain. An AVM is a congenital (present at birth) or acquired disorder that consists of a disorderly, tangled web of arteries and veins. An AVM also has a risk for rupturing and bleeding into the brain. Surgery may be helpful, in this case, to help prevent a stroke from occurring. • Patent foramen ovale (PFO) closure The foramen ovale is an opening that occurs in the wall between the two upper chambers of a baby's heart before birth. It functions to provide oxygen-rich blood to the baby from the mother's placenta while in the womb. This opening normally closes soon after birth. If the flap does not close, blood flows from the right atrium directly to the left atrium. It then flows out to the central circulation of the body. If this blood contains any clots or air bubbles, they can pass into the brain circulation causing a stroke or transient ischemic attack (TIA). PFO closure procedure can be performed through a percutaneous (through the skin) approach. Signs and symptoms of a PFO may not occur until early or middle adulthood and may even go

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