Description
Stroke is one of the leading causes of death and disability in India. The estimated adjusted prevalence rate of stroke range, 84-262/100,000 in rural and 334-424/100,000 in urban areas.A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. A stroke is a medical emergency, and prompt treatment is crucial.
Résumé
- Stroke is the third leading cause of death and can be defined as sudden brain damage due to vascular causes like ischemic or hemorrhagic events. Common features include weakness, speech disturbances, visual deficits, seizures, headaches, coma, and swallowing difficulties. Prompt hospitalization is crucial within the window period, particularly for ischemic strokes where thrombolytic agents can be administered.
- Upon hospital admission, the patient is stabilized, and neuroimaging (typically a CT scan) is performed to determine the type of stroke. Treatment may involve conservative management, thrombolytic agents for ischemic strokes, or surgical intervention for severe edema or hemorrhage. Clinically stable patients are then assessed for transfer to a rehabilitation facility.
- Rehabilitation focuses on preventing and treating complications, managing pre-existing conditions, and addressing deficits caused by the stroke. Common complications include deep venous thrombosis (DVT), pressure sores, respiratory and urinary tract infections, spasticity, and contractures. Prevention strategies are crucial in managing these issues.
- Specific interventions for complications include anticoagulation and early mobilization for DVT, frequent repositioning and specialized mattresses for pressure sores, chest therapy for respiratory infections, and proper catheter care for UTI prevention. Spasticity and contractures are managed through positioning, stretching, oral medications, and, in some cases, botulinum toxin injections.
- Daily rounds involve monitoring nutrition, hydration, electrolyte balance, hygiene, and potential stress ulcers. Tracheostomy care is essential for patients with breathing difficulties, and PEG tubes are considered for long-term feeding. Proper limb positioning and bowel/bladder management are also key aspects of patient care.
- Motor weakness is addressed with range of motion exercises, splints/orthotics, electrical stimulation, and robotic therapy. Occupational therapy focuses on functional training and compensatory techniques. Speech and swallow therapy addresses communication and swallowing difficulties, often involving cognitive training and psychological support.
- Pain management in stroke patients, particularly shoulder pain, is addressed through medication, physical therapy, and interventions like steroid injections or nerve blocks. The prognosis is best within the first three months, and therapy should continue for at least a year. Recovery prospects depend on the affected brain area, with lower limb recovery often better than upper limb recovery, and proximal muscles recovering more effectively than distal muscles.
Exemple de certificat
À propos des intervenants
Dr. Anirudh Chirania
COO and Consultant Physiatrist at APOKOS rehab hospital Hyderabad
Divulgation financière
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