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What are the Primary Risk Factors of Stroke
- Hypertension
- Heart Disease
- Diabetes Mellitus
- Smoking
- TIA's
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What are the Secondary Risk Factors to Strokes
- Obesity
- High Cholesterol
- Behaviors related to hypertension
- Physical Inactivity
- increase alcohol consumption
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What is a Ischemic Stroke?
- Loss of perfusion to a portions of the brain
- 85-90%
- Embolus - 20%
- Thrombus 80%
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What is a Hemorrhagic Stroke?
- Abnormal Bleeding into the brain
- 10-15%
- More fragile
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How is a stroke diagnosed?
- Neurologcial exam
- blood and urine work
- CT, MRI, PET, Carotid Doppler, Cerebral Angiography
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What is medical management for a Stroke?
- Mangage BP and ICP
- Anticoagulant meds
- Posible neurosurgery
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What are signs of left hemiplegia?
- Visual perception problems, neglect
- Impulsive
- Decreased Problem solving
- Often unaware of impairments
- Rigid Thinking - safety risk
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What are signs of right hemiplegia?
- Speech and language problems
- Decreased planning, sequencing
- Very aware of impairments and anxious
- Slow and cautious
- Difficulty processing verbal cues
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What are Impairments fo a Brainstem Lesion?
- Unstable vital signs
- Decreased consciousness
- Decreased ability to swallow
- Weakness of both sides of the body
- Paralysis on both sides of the body
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What are impairments of a Cerebellum lesion?
- Decreased balance
- Ataxia
- Decreased coordination
- Nausea
- Decreased ability for postural adjustment
- Nystagmus
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Secdondary Impairments/Complictions
- Contractures, Decubitus Ulcers
- DVT
- Cardiac Arhythmias
- Limitied pulmonary capacity/ pneumondia
- orthostatic hypotension
- Depression
- RSD, CRPS
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Common Gait Deviations with a Stroke
- Hip - protraction, trendelenberg, hip hiking, circumduction during gait
- Knee- buckling or hyperextension during stance
- Ankle - Foot drag, increase tone = PF and IV
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Ways to decrease tone
Ice packs, estime or vibrations to antogonist, air splints, weight bearing
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