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Chapter 7: 10 Real Cases on Transient Ischemic Attack and Stroke: Diagnosis, Management, and Follow-Up
Jeirym Miranda; Fareeha S. Alavi; Muhammad Saad
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Case review, case discussion, clinical symptoms.
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Case 1: Management of Acute Thrombotic Cerebrovascular Accident Post Recombinant Tissue Plasminogen Activator Therapy
A 59-year-old Hispanic man presented with right upper and lower extremity weakness, associated with facial drop and slurred speech starting 2 hours before the presentation. He denied visual disturbance, headache, chest pain, palpitations, dyspnea, dysphagia, fever, dizziness, loss of consciousness, bowel or urinary incontinence, or trauma. His medical history was significant for uncontrolled type 2 diabetes mellitus, hypertension, hyperlipidemia, and benign prostatic hypertrophy. Social history included cigarette smoking (1 pack per day for 20 years) and alcohol intake of 3 to 4 beers daily. Family history was not significant, and he did not remember his medications. In the emergency department, his vital signs were stable. His physical examination was remarkable for right-sided facial droop, dysarthria, and right-sided hemiplegia. The rest of the examination findings were insignificant. His National Institutes of Health Stroke Scale (NIHSS) score was calculated as 7. Initial CT angiogram of head and neck reported no acute intracranial findings. The neurology team was consulted, and intravenous recombinant tissue plasminogen activator (t-PA) was administered along with high-intensity statin therapy. The patient was admitted to the intensive care unit where his hemodynamics were monitored for 24 hours and later transferred to the telemetry unit. MRI of the head revealed an acute 1.7-cm infarct of the left periventricular white matter and posterior left basal ganglia. How would you manage this case?
This case scenario presents a patient with acute ischemic cerebrovascular accident (CVA) requiring intravenous t-PA. Diagnosis was based on clinical neurologic symptoms and an NIHSS score of 7 and was later confirmed by neuroimaging. He had multiple comorbidities, including hypertension, diabetes, dyslipidemia, and smoking history, which put him at a higher risk for developing cardiovascular disease. Because his symptoms started within 4.5 hours of presentation, he was deemed to be a candidate for thrombolytics. The eligibility time line is estimated either by self-report or last witness of baseline status.
Ischemic strokes are caused by an obstruction of a blood vessel, which irrigates the brain mainly secondary to the development of atherosclerotic changes, leading to cerebral thrombosis and embolism. Diagnosis is made based on presenting symptoms and CT/MRI of the head, and the treatment is focused on cerebral reperfusion based on eligibility criteria and timing of presentation.
Symptoms include alteration of sensorium, numbness, decreased motor strength, facial drop, dysarthria, ataxia, visual disturbance, dizziness, and headache.
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CVA and ICP Case Study PPT STUDENT COPY Part 1 CVA
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Ischemic stroke clinical case, it seems that you like this template, ischemic stroke clinical case presentation, free google slides theme, powerpoint template, and canva presentation template.
An ischemic stroke is what happens when one of the vessels that supply the brain gets obstructed, and it can cause serious damage to the brain. In order to identify when something like this might be happening to us, we must go FAST. This doesn’t mean that we should rush, FAST is the acronym of Face dropping, Arm weakness, Speech difficulty and Time to call 911. Those are the things you need to identify as soon as possible to lessen the effects of a stroke. Are you aware of techniques like this one? Or maybe you have developed a new treatment for people affected? With this template that combines red and white you can explain it all in detail! The information will be crystal clear thanks to the different resources we have included to help you give medical data: graphs, maps, charts… Everything is editable, so you can adapt the presentation to your needs. Download it now and start preparing a presentation that will save lifes!
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This presents an analysis of a case of Ischemic stroke in terms of possible etiology, pathophysiology, drug analysis and nursing care
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Ischemic stroke: A case study
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- Martinez, Rudolf Cymorr Kirby P. ;
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Clinical Focus: Adult Medical/Surgical
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NIHSS 23 on presentation, consistent with large left MCA syndrome. Non-contrast head CT showed a dense L MCA (figure 1A) without early infarct changes, ASPECTS 10 (figure 1B). He received Alteplase IV r-tPA with a door-to-needle time of 27 minutes, 54 minutes from symptom onset.
Alteplase (IV r-tPA) within. 4.5 hours of stroke onset. 1.9 times as likely to have a favorable outcome. Mechanical thrombectomy for patients with large vessel occlusion within 6 hours of stroke onset. 70% improvement with patients*. Improved early neurological recovery. Improved functional outcome at 3 months.
Cerebral Vascular Accident (CVA) John Gates, 59 years old Primary Concept Perfusion Interrelated Concepts (In order of emphasis) 1. Stress 2. Coping
NIHSS 23 on presentation, consistent with large left MCA syndrome. Non-contrast head CT showed a dense L MCA (figure 1A) without early infarct changes, ASPECTS 10 (figure 1B). He received Alteplase IV r-tPA with a door-to-needle time of 27 minutes, 54 minutes from symptom onset.
This case scenario presents a patient with acute ischemic cerebrovascular accident (CVA) requiring intravenous t-PA. Diagnosis was based on clinical neurologic symptoms and an NIHSS score of 7 and was later confirmed by neuroimaging.
CVA case study - LPN Program. John Gates, a 59-year-old male with a history of diabetes type II and... View more. Course. Foundations of Clinical Nursing (KSPN-0104) ... C. Diff Sepsis - Case Study - C. difficile Sepsis Unfolding Reasoning Minnie Taylor, 62 years old - Studocu;
Tissue plasminogen activator is a protein involved. in the breakdown of blood clots. It catalyzes the conversion of plasminogen to. plasmin, the major enzyme responsible for clot. breakdown. •. Rapid diagnosis of ischemic CVA and initiation. of TPA within 3-4.5 hours leads to a decrease in.
Free Google Slides theme, PowerPoint template, and Canva presentation template. An ischemic stroke is what happens when one of the vessels that supply the brain gets obstructed, and it can cause serious damage to the brain. In order to identify when something like this might be happening to us, we must go FAST.
General Submissions: Presentations (Oral and Poster) Ischemic stroke: A case study. Rudolf Cymorr Kirby P. Martinez, PhD, MA, RN, CAA, LMT, CSTP, FRIN. Item Link - Use this link for citations and online mentions. This presents an analysis of a case of Ischemic stroke in terms of possible etiology, pathophysiology, drug analysis and nursing care.