Arteriovenous malformation – uncommon abnormality resulting in a tangled collection of malformed, thin-walled, dilated vessels WITHOUT capillary network which leaves veins subjected to arterial pressure **an occlusive stroke can convert to a hemorrhagic stroke** Assessment
Assess LOC – sudden decrease or alteration could be hypoglycemia or hypoxia RULE THESE OUT FIRST Stroke assessment for severity use the NIH Stroke Scale – scores stroke from 0-42 (higher the number more severe) [chart found on page 935 with complete scale] Assess cranial nerves CN V – ability to chew CN IX and X – ability to swallow CN VII – facial paralysis/pariesis CN IX – absent gag reflex CN XII – impaired tongue movement o ** remember pt with dysphagia is at risk for aspiration pneumonia** Cardiovascular assessment o Pt w/ embolic stroke – assess for heart murmur, dysrhythmias (especially afib), or HTN o BP of 150/100 mm Hg is needed to maintain cerebral perfusion after an acute ISCHEMIC stroke CT Scan o Done w/out contrast o Usually initially negative w/ ischemic stroke will start showing signs of ischemia, infarction and cerebral edema after 24 hours o Establishes baseline in case of deterioration o Can also identify cerebral aneurysm, AVM, brain tumor, or cerebral hematoma MRI – shows brain injury earlier than CT MRA o Enhances sensitivity of MRI to detect early changes in the brain o Can confirm blood flow Carotid duplex scanning – determine additional cardiovascular risk
You've reached the end of your free preview.
Want to read all 4 pages?
- Winter '16
- ischemic stroke, Middle cerebral artery, hemorrhagic stroke, acute ischemic stroke, w/ ischemic stroke