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1、CerebrovascularStrokeDr.Abdul-MonimBatihaAssistantProfessorCriticalCareNursingCerebrovasculardiseaseisthemostfrequentneurologicaldisorderofadults.ItisthethirdleadingcauseofmorbidityandmortalityintheUSAafterheartdiseaseandcancer.Itincludesanypathologicalprocessthatinvolvesthebloodvesse
2、lsofthebrain.Mostcerebrovasculardiseaseiscausedbythrombosis,embolism,orhemorrhage.Themechanismofeachoftheseetiologiesisdifferent,buttheultimateresultisdamagetoafocalareaofthebrain.CerebrovascularDiseaseA“brainattack”mustbeviewedasamedicalemergency.Toreversecerebralischemia,patientsmus
3、tbeevaluatedpromptly.Ischemicbraininjuryoccurswhenarterialocclusionlastslongerthan2to3hours.Delayinseekingmedicalcaremayeliminatethepotentialfortissue-savingtherapywiththrombolyticagents.Stroke“brainattack”Astrokemaybedefinedasaneurologicaldeficitthathasasuddenonset,lastsmorethan24hou
4、rs,andresultsfromcerebrovasculardisease.Astrokeoccurswhenthereisadisruptionofbloodflowtoaregionofthebrain.Bloodflowisdisruptedbecauseofanobstructionofavessel,onaccountofathrombusorembolus,ortheruptureofavessel.Theclinicalfeaturesseendependonthelocationoftheeventandregionofthebrainthev
5、esselperfused.Stroke“brainattack”Approximatelythree-fourthsofstrokesareduetovascularobstruction(thrombioremboli),resultinginischemiaandinfarction.Aboutone-fourthofstrokesarehemorrhagic,resultingfromhypertensivevasculardisease(whichcausesanintracerebralhemorrhage),arupturedaneurysm,ora
6、narteriovenousmalformation.ETIOLOGYClassificationofstrokeApproximately750,000strokesoccureveryyearintheUSTheincidenceinmenisgreaterthaninwomen.Itisestimatedthatthereare3millionstrokesurvivorsandthatstrokeisaleadingcauseofdisabilityandaleadingdiagnosisforlong-termcare.EPIDEMIOLOGYRiskf
7、actorsforstrokeincludesmoking,hypertension,obesity,cardiacdisease,hypercholesterolemia,diabetes,anduseofbirthcontrolpills.Preventioneffortsfocusonlifestylechangesthatcanmodifyriskfactors.Inaddition,theappropriateuseofwarfarinoraspirininpatientsatriskforcardiacsourcesofemboli(e.g.,atri
8、alfib
