com·pen·di·umkəmˈpendēəm/Noun

a collection of concise but detailed information about a particular subject, especially in a book or other publication

Four PrinciplesSTROKE is a brain attack.

STROKE is an emergency.

Four PrinciplesSTROKE is treatable.

STROKE is preventable.

DefinitionsStroke

Clinical syndrome of rapid onset of brain deficits of lasting more than 24 hours or leading to death

DefinitionsTransient Ischemic attack (TIA)

Clinical syndrome of rapid onset of brain deficits which resolves within 24 hours

DefinitionsProgressive Stroke

A stroke in which the focal neurological deficits worsen with time

Completed StrokeA stroke in which the focal neurological deficits

persist and do not worsen with time

BRAIN STROKE

Philippines' 2nd cause of death.

Prevalence of 1%

schemic stroke comprises 70%

hemorrhagic stroke comprises 30%

BRAIN STROKE (PH)

BRAIN STROKE (PH)

neurologist-to-patient ratio is 1:330,000

67% of neurologists in urban centers

Anterior Circulation

Posterior Circulation

Types of Stroke

Ischemic Stroke80% of strokes

Arterial occlusion of an intracranial vessel

Two etiological typesThromboticEmbolic

Etiology of ischemic stroke

Etiology of ischemic stroke

Etiology of ischemic stroke

Thrombotic Stroke

Atherosclerosis is the most common pathology leading to thrombotic occlusion of blood vessels

Hypercoagulable disorders

Etiology of ischemic stroke

Blood flowIf zero leads to death of brain tissue within 4-

10min

Pathophysiology of Ischemic Stroke

Intracerebral Hemorrhage• Result of chronic hypertension

• Small arteries are damaged due to hypertension

• In advanced stages vessel wall is disrupted and leads to leakage

• Headache

CLINICAL FEATURES

HistoryOnset and progression of neurological

symptoms?

History of previous TIAs

History of hypertension & diabetes mellitus

History of heart conditions like arrhythmias, RHD & prosthetic valves

History of seizures & migraine

History of anticoagulant therapy

History of oral contraceptive use

History

History of any hypercoagulable disorders like cancer

Substance abuse: cocaine, amphetamines

History

General featureabrupt onset of a focal neurologic deficit

manifestations of stroke are highly variable

DIFFERENTIAL DIAGNOSIS

Hypoglycemia

Space Occupying Lesions

SEIZURES AND POST SEIZURE STATES

MIGRAINE MIGRAINE

INVESTIGATION MODALITIES: BRAIN

ISCHEMIC LESION

TREATMENT OBJECTIVES

1. MINIMIZE VOLUME OF BRAIN IRREVERSIBLY DAMAGED

2. PREVENT COMPLICATIONS

3. REHABILITATION

4. REDUCE RISK OF RECCURENCE

REHABILITATIONPHYSIOTHERAPY - as early as

possible - prevents contractures,

spasticity and atrophy

REHABILITATIONSPEECH THERAPY

IMPROVE QUALITY OF LIFE WITH MOTOR AIDS

PREVENTIONBlood pressure control

Diabetes Management

Lipid Management

Smoking Cessation

Alcohol Moderation

PREVENTIONWeight Reduction/Physical

Activity

Carotid Artery Interventions

PREVENTIONAnti platelet agents /

Anti coagulants

Statins

PROGNOSISISCHEMIC STROKE

Mortality rate in first 30 days is 8-12%

First 3 hrs after stroke - GOLDEN PERIOD

PROGNOSIS INTRACEREBRAL HAEMORRHAGE

Mortality rate in first 30 days is almost 50%

Prognosis compared to ischemic type .

Four PrinciplesSTROKE is a brain attack.

STROKE is an emergency.

STROKE is treatable.STROKE is preventable.