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CNS pathology for thephysiotherapists
STROKEDr Yasar Yousafzai
Assistant Professor HaematologyKhyer !e"i#al $ni%ersity
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STROKE
Also &no'n as #erero%as#ular a##i"ent
Neurologi#al "efi#it of #ereral #auses thatpersists eyon" ()
hours or is interrupte" y
"eath 'ithin () hours Transient is#hemi# atta#&
*hen poor loo" flo' results in "eath of rain
#ells +n 'hat #on"itions 'oul" there e poor loo"
flo',
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Stro&e
*hat 'ill #ause a stro&e,
*hat 'oul" "eath of CNS tissue lea" to,
Thin& ho' is#hemia 'ill effe#t rain fun#tion,
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Stro&e
*hen the loo" stops flo'ing----
+s#hemi# stro&e
Haemarrhagi# stro&e
+s#hemi# stro&e
./0 stro&e #ases are "ue to is#hemia
+s#hemi# stro&e may ultimately e#omehaemorrhagi#
Cause" y thromosis1 emolism1 sho#&1atheros#lerosis
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+s#hemi# stro&e
Small infar#ts may go 'ithout #lini#al symptoms
Total anterior #ir#ulation infar#t
Partial anterior #ir#ulation infar#t
2a#unar infar#t
Posterior #ir#ulation infar#t
Etiologi#ally
Atheros#lerosis of large artery
Emolism originating in the heart
Complete lo#&age of a small artery
$n"etermine" #ause
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Haemorrhagi# stro&e
+ntra#ranial haemorrhage is "efine" asa##umulation of loo"
'ithin the #ranial #a%ity
!ain types
Epi"ural haematoma
Su"ural haematoma
Suara#hnoi" haemorrhage
Cereral haemorrhage
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Symptoms an" signs
Typi#ally start su""enly
Hemiplagia an" mus#le 'ea&ness
Numness
Re"u#tion in sensations an" %iration
3la#i"ity follo'e" y spasti#ity
$sually unilateral- *hy, Altere" smell1 taste1 %ision
3a#ial mus#le paralysis
De#rease" refle4es
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Stro&e signs an" symptoms
+f the #ereral #orte4 is in%ol%e"1 CNSpath'ays may e affe#te"
lea"ing to6
Aphasia 7 "iffi#ulty 'ith %eral e4pression
Dysarthria 7 motor spee#h "isor"ers Apra4ia 7 in%oluntary
mo%ements
8isual fiel" "efe#ts
!emory "efi#it heminegle#t
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Stro&e "iagnosis
History an" #lini#al e4amination
CT s#an
!R+
Doppler ultrasoun"
Diagnosis of the un"erlying #ause
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Stro&e management
Treatment is a##or"ing to the #ause
Thromolyti# therapy
Surgery 7 thromo"e#tomy
Nursing an" supplementary #are
Stro&e unit
!anagement of the pre"isposing #ause
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Stro&e management
Stro&e rehailitation
A pro#ess y 'hi#h stro&e patients are rehailitate"to help
them return to normal life as mu#h as
possile A rehailitation team is usually multi"is#iplinary as
it in%ol%es staff 'ith "ifferent s&ills 'or&ing
togetherto help the patient
+nter"is#iplinary team #onsisting of Do#tors1 nurses1 physi#al
therapists1 spee#h
therapists1 o##upational therapists
