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Assessment of Hemiplegia Post-Stroke

The document provides an overview of stroke, defining it as a cerebrovascular accident that leads to sudden neurological dysfunction due to disrupted blood flow to the brain. It distinguishes between ischemic and hemorrhagic strokes, outlines risk factors such as hypertension and diabetes, and describes the pathophysiological processes involved in stroke, including neuronal death and the ischemic cascade. Hemiplegia is highlighted as a common consequence of stroke, with severity influenced by various factors including the extent of brain injury and early management.

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Tasbiha salim
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16 views4 pages

Assessment of Hemiplegia Post-Stroke

The document provides an overview of stroke, defining it as a cerebrovascular accident that leads to sudden neurological dysfunction due to disrupted blood flow to the brain. It distinguishes between ischemic and hemorrhagic strokes, outlines risk factors such as hypertension and diabetes, and describes the pathophysiological processes involved in stroke, including neuronal death and the ischemic cascade. Hemiplegia is highlighted as a common consequence of stroke, with severity influenced by various factors including the extent of brain injury and early management.

Uploaded by

Tasbiha salim
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Assessment in Hemiplegic patients

De nition of stroke : Cerebrovascular accident (CVA) is the sudden


loss of neurological function caused by an interruption of blood ow to
the brain.

Types of stroke.

Ischemic stroke. Hemorrhagic stroke

Ishemic stroke: Ischemic stroke is the most common type , affecting


about 80% of individuals with stroke , and can be the result of a
thrombosis, embolism, or hypoperfusion.
Hemorrhagic stroke : Occurs when the blood vessels rupture causing
leakage of blood in or around the brain. Clinically , a variety of focal
de cits are possible, including changes in level of consciousness and
impairments of sensory, motor , cognitive, perceptual , and language
functions.

To be classi ed as stroke, neurological de cits are characterised by


paralysis (hemiplegia) or weakness (hemiparesis) , typically on the
side of the body opposite side of the lesion.

Hemiplegia : The term hemiplegia is often used generally to refer to


wide variety of motor problems that result from stroke. The location
and extent of brain injury, the amount of collateral blood ow, and
early acute care management determine the severity of neurological
de cits in an individual patient.
RISK FACTORS

Cardiovascular disease affecting the brain and heart share a number


of common risk factors important to the development of
atherosclerosis (build up fats, cholesterol & other substances in & on
the arteries walls).
Major risk factors for stroke are - hypertension, diabetes mellitus,
disorders of heart rhythm, high blood cholesterol, smoking/ tobacco
use & heart disease (HD).

PATHOPHYSIOLOGY:
- Sudden loss of O2 , glucose and cerebral blood ow deprivation.
- within minutes neutrons die within the ischemic core. While neurons
in the surrounding forming penumbra survive for slightly longer( for
penumbra to survive 20-25% blood ow should be present).

- Ischemia triggers a ischemic cascade. It causes neurotransmitters


to release glutamate and aspartate.

- This produces progressive disturbances of energy mechanisms and


anoxic depolarisation which results in an inability to produce ATP.

- It leads to excess in ux of calcium and pump failure of neuronal


membrane.

- Excess calcium reacts with intracellular phospholipids to form free


radicals.

- Calcium in ux also stimulates the release of nitric oxide and


cytokines . Both mechanisms further damage brain cell.

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