ALTERATIONS IN THE NERVOUS SYSTEM TREATMENT OF CVA
- Slides: 13
ALTERATIONS IN THE NERVOUS SYSTEM TREATMENT OF CVA
Cerebrovascular Accident Goals for Management CT Scan – No hemorrhage: ◦ Consider Fibrinolytic therapy Check for exclusions t. PA No anticoagulants or antiplatelet therapy for 24 hours ◦ If not a candidate: Antiplatelet Therapy CT Scan – Hemorrhage: ◦ Neurosurgery? ◦ If no surgery: Stroke Unit Monitor BP and treat Hypertension Monitor Neuro status Monitor blood glucose and treat as needed Supportive therapy
Thrombolytic Therapy IV (systemic) thrombolytic Retavase (rt. PA) Eligibility criteria therapy -no bleeding disorder -no recent surgeries -not on anticoagulants Intra-arterial thrombolysis pro-urokinase* *http: //emedicine. medscape. com/article/1160840 -overview
Treatment for Ischemic Stroke • Thrombolytic Drugs: rt. PA (recombinant tissue plasminogen activator) Retavase • binds to thrombi fibrin causing fibrinolysis • Enzymatic action digests fibrin & fibrinogen • Results is clot lysis • Administered within 3 hours of symptoms of ischemic CVA • Confirmed DX with CT • Patient anticoagulated • ASA, Calcium Channel Blockers
Drug Therapy Thrombolytic therapy Anticoagulants Lorazepam and other antiepileptic drugs Calcium channel blockers Stool softeners Analgesics for pain Antianxiety drugs
Medications Anticoagulants: to prevent further clot formation (heparin) Lorazepam and other antiepileptics: to prevent seizure activity Calcium channel blockers: to treat or prevent cerebral vasospasm(verapamil)
Medications Continued Stool softeners: to prevent constipation Analgesics for pain Antianxiety drugs
CVA – Surgical Treatment • Carotid endarterectomy – preventive – > 100, 000/year • removal of atheromatous lesions • Extracranial-intracranial bypass • Clipping, wrapping, coiling aneurysm • Treatment of AV Malformations
Hemorrhagic-Subarachnoid Cerebral Aneurysm – Surgical Tx
Hemorrhagic-Subarachnoid Cerebral Aneurysm – Coiling
Video of wire coils to treat aneuryms http: //www. veoh. com/browse/videos/categ ory/entertainment/watch/v 18668828 WJmj 4 g. Ra
Other Potential Measures Cooling Ancrod Neuroprotective drugs
Label the different types of neuronal pools in the figure.
Nervous
Neuronal pools are collections of
Alterations of chromosome structure
Cyclical theory of social change
Sites of taking pulse
"identify client problems and related health alterations."
Anatomical location
Unauthorised alterations to common property
Alterations in the structure of an organism
Alteration in urinary elimination
Nervous system and digestive system
Endocrine system and nervous system
Amino acid-based hormones
