Case: Mr. Quinn, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Quinn has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.
Question 1
Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma.
Thrombus occurs when there is a blood clot that forms in the arteries of the brain, while an embolic stroke occurs when there is a blood in another part of the body like the heart that dislodges and flows up to the smaller arteries of the brain where it gets stuck. Atheroma is the gradual narrowing of the artery. This is due to plaque and thrombus. Usually, it occurs over a period of time.
Question 2
Explain the predisposing factors in this case, and relate Mr. Quinn’s initial signs to the pathological changes.
Predisposing factors in Mr. Quinn’s case would be the narrowing of the carotid and middle cerebral arteries, also occlusion of the left middle cerebral artery. Initial signs would be headache, anxiousness, numbness and loss of speech.
Question 3
Discuss the treatments available after first aid for stroke patients and the patient’s prognosis.
Treatments available are; tissue plasminogen activator (TAP) to reduce effects of CVA, glucocorticoids to reduce edema, assisting to maintain muscle tone, therapists, speech therapy, treating underlying problem.
0
1332