Chapter 45: Care of Critically Ill Patients w/ Neurologic Problems TIA – Transient Ischemic Attack Temporary neurologic dysfunction resulting from a BRIEF INTERRUPTION in cerebral blood flow. Symptoms typically resolve w/in 30-60 minutes S/S: visual deficits ( blurred vision, diplopia, one sided blindness, and tunnel vision); Motor deficits ( weakness, facial droop, arm or leg drift, weak had grasp, and ataxia [gait disturbance]); sensory perception deficits ( face, hand, arm or leg numbness or vertigo); and speech deficits (aphasia or dysarthria [slurred speech]) 1 TIA – increases risk for stroke Multiple TIA – increased risk for permanent brain damage Do complete neuro assessment, lab tests, ECG and CT in the ED Tx: FOCUS ON PREVENTING FURTHER TIA o Reduce high BP (add or adjust drugs) o Take asprin or Plavix (antiplatelet drugs) o Control diabetes (between 100-180) o Quit smoking, eat healthier, be more active Stroke (Brain Attack) Caused by interruption of perfusion to the brain (THIS IS A MEDICAL EMERGENCY ) Brain needs constant blood flow to provide glucose and oxygen and rid the brain of metabolic waste Infarction ( NO OXYGEN TISSUE DEATH ) occurs after few minutes resulting in disability Stroke may also affect contralateral (opposite) side of brain due to edema or global change in perfusion o Brain edema can then lead to increased ICP and 2ndary brain damage Types of Strokes Ischemic Stroke ( occlusive – either thrombotic [blood clot] or embolic [clot that is dislodged]) Thrombotic – most common
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- Winter '16
- ischemic stroke, Middle cerebral artery, hemorrhagic stroke, acute ischemic stroke, w/ ischemic stroke