What is stroke?
Stroke is defined as condition in which the brain function is interrupted rapidly due to the loss of blood supply
as a result of the blockage of blood such as thrombosis and arterial
embolism, or leakage of blood causes of the death of brain cells,
according to the article of Mitochondria, oxidative metabolism and cell death in stroke by Sims NR, Muyderman H (September 2009).
Stroke is caused by cholesterol build up in the arteries and high blood
pressure. In other words, if cholesterol building up in the arteries is
blocking the circulation of blood in any part of the body causing
oxygen not to be delivered to the brain, resulting in some cells in the
brain to die off and are unable reproduce,
Besides cancer and heart
diseases, stroke is the third leading cause of death. Approximate 1/4 of
all stroke victims die as a direct result of the stroke or it's
complications.
Women and stroke
According
to the statistic of the Heart and Stroke Foundation, strokes kill 45%
more women than men in Canada. In the study, published in the journal Neurology,
researchers from the University of California at Los Angeles monitored
17,000 people over a period of six years. They found the incidence of
stroke rising faster among women than men.When women reach the age of
45, the risk of stroke begins to rise rapidly, it may be due to levels
of estrogen has dropped significantly at age 45 and onward.
Treatments
Depending to the location of the occurrence
A. Ischemic stroke
1. Thrombolysis
The
aims of thrombolysis is to resolve the blood clot to improve the blood
flow to prevent further damage to tissue and organs in the body as the
medicine break down the blood clot by stimulating fibrinolysis through
infusion of a protein involved in the breakdown of blood clots called
tissue plasminogen activator.
2. Mechanical thrombectomy
As it
name, it is the mechanical to remove the blood clot directly by
inserting a catheter, a long, into the large arteries in the thigh, then
directing it into the blood vessels supplying blood the brain to
dissolve the blood clot thus effectively restoring blood flow., by
applying a with a corkscrew-like clot-removing device. The mechanical
thrombectomy is used when the patient for what ever reason can not
tolerate the thrombolysis.
3. Anticoagulation
According to the
study of Meta-analysis: antithrombotic therapy to prevent stroke in
patients who have nonvalvular atrial fibrillation by Hart RG, Pearce LA,
Aguilar MI, researchers found that Adjusted-dose warfarin and
antiplatelet agents reduce stroke by approximately 60% and by
approximately 20%, respectively, in patients who have atrial
fibrillation. Warfarin is substantially more efficacious (by
approximately 40%) than antiplatelet therapy.
4. Etc.
B. Hemorrhagic stroke
Since
Hemorrhagic stroke involves bleeding within the brain, which damages
nearby brain tissue, therefore the use of anticoagulant can make the
matter worse. In most cases, it requires neurosurgical evaluation to
locate before the cause before it can be treated effectively such as
occupational therapy, physical therapy, speech therapy, etc.
Care and rehabilitation
A. The impotant of care and rehabilitation of stroke patient
1.
In a study of The Care and Rehabilitation of Stroke Patients One Year
Following the Event N. Bentur, M. Davis, J. Brodsky, J. Gindin, B.
Habot, Z. Haklai, A. Shemesh, researchers found that
significant
differences among wards and hospitals, and highlight the need to develop
criteria, standards, and clinical guidelines for the diagnosis and
treatment of stroke patients. The brevity of the hospital stay and the
small quantity of community rehabilitation services, along with the
complexity of stroke, emphasize the need to determine the best discharge
destination. The findings of this study were discussed by the National
Geriatric Council and served as a basis for discussions in the Ministry
of Health. The Ministry has instructed the health plans and hospital
directors not to send individuals who need rehabilitation to long-term
care institutions, so that patients can maximize their functional
potential after stroke. The finding that rehabilitation services in the
community are limited, emphasizes a need to examine the reasons for
barriers to these services, as well as how to expand them and develop
alternative patterns of rehabilitation in the community. The study also
identified a need to examine National Health Insurance Law regulations
on the rehabilitative services that the health plans are obligated to
provide. Thought should be given to the health plans’ activity in this
area, so as to ensure that services are appropriate.
2. In a
study of The efficacy of self-care education on rehabilitation of stroke
patients. Sahebalzamani M, Aliloo L, Shakibi A, researchers found that
Self-care education of stroke survivors can improve patient's
performance, and change them from a dependent to an independent person.
3. Etc.
B. Post-Stroke Rehabilitation. Clinical Practice Guideline
I will leave this article, for a link where you can find the charter 16 - Post-Stroke Rehabilitation by
The Agency for Health Care Policy and Research (AHCPR) was established
in December 1989 under Public Law 101-239 (Omnibus Budget Reconciliation
Act of 1989) to enhance the quality, appropriateness, and effectiveness
of health care services and access to these services.
Since this
publication is dated in may -1995, and is provided for historical
reference only and the information may be out of date or incorrect.
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