بخشی از پاورپوینت
اسلاید 1 :
مدیریت درمان سکته حادمفزی
اسلاید 2 :
سومین علت مرگ در دنیا
اولین علت ناتوانی طولانی مدت
سکته حاد مغزی
اسلاید 3 :
استروك ممكن است ایسكمیك یا هموراژیك باشد
حدود 87% استروكها ایسكمیك، 10% ICHو 3% SAH است
اسلاید 4 :
سكته های هموراژیك علیرغم شیوع كمتر، مورتالیتی بیشتری دارند.
حدود 8 تا 12% سكته های ایسكمیك و 37 تا 38% سكته های هموراژیك تا30 روز بعد از وقوع احتمال مرگ و میر دارد.
هزینه مراقبت و كاهش بهرهوری افراد در آمریكا حدود 76.6میلیارد دلار در سال (سال 2012)
اسلاید 5 :
Intra-cerebral haemorrhage
Sub-arachnoid haemorrhage
اسلاید 6 :
Hypodensity
2. Identify early ischaemic damage
اسلاید 7 :
سکته مغزی به تنهایی عامل 13 % موارد مرگ در ایران (گزارش سیمای سلامت 1388 از وضعیت مرگ در سال 83)
اپیدمیولوژی در ایران
اسلاید 10 :
Saving the penumbra
اسلاید 11 :
The penumbra is moderately ischaemic tissue that may remain salvageable for several hours if reperfusion takes place1,2
1. Saver J. Stroke 2006;37:263-266.
2. Moustafa RR, Baron JC. Br J Pharmacol 2008;153:S44-S54.
Every second counts1
Thrombolysis needs to be given as early as possible to prevent the conversion of potentially viable brain tissue in the penumbra from becoming completely ischaemic and dying
Cerebral blood flow pattern after middle cerebral artery occlusion
Onset of stroke:
death of brain cells within minutes1
Infarct
Penumbra
اسلاید 12 :
The penumbra is moderately ischaemic tissue that may remain salvageable for several hours if reperfusion takes place1,2
1. Saver J. Stroke 2006;37:263-266.
2. Moustafa RR, Baron JC. Br J Pharmacol 2008;153:S44-S54.
Every second counts1
Thrombolysis needs to be given as early as possible to prevent the conversion of potentially viable brain tissue in the penumbra from becoming completely ischaemic and dying
Cerebral blood flow pattern after middle cerebral artery occlusion
Onset of stroke:
death of brain cells within minutes1
Infarct
Penumbra
اسلاید 13 :
The area of infarct represents severe ischaemia2
1. Saver J. Stroke 2006;37:263-266.
2. Moustafa RR, Baron JC. Br J Pharmacol 2008;153:S44-S54.
Every second counts1
Thrombolysis needs to be given as early as possible to prevent the conversion of potentially viable brain tissue in the penumbra from becoming completely ischaemic and dying
Cerebral blood flow pattern after middle cerebral artery occlusion
6 hours after stroke onset
Infarct
Penumbra
اسلاید 14 :
The area of infarct represents severe ischaemia2
1. Saver J. Stroke 2006;37:263-266.
2. Moustafa RR, Baron JC. Br J Pharmacol 2008;153:S44-S54.
Every second counts1
Thrombolysis needs to be given as early as possible to prevent the conversion of potentially viable brain tissue in the penumbra from becoming completely ischaemic and dying
Cerebral blood flow pattern after middle cerebral artery occlusion
24 hours after stroke onset
Infarct
Penumbra
اسلاید 15 :
Areas of ischaemia following middle cerebral artery occlusion before (left) and after (right) reperfusion
Time is Brain Tissue1
An untreated patient loses approximately 1.9 million neurons every minute in the ischaemic area1
Reperfusion offers the potential to reduce the extent of ischaemic injury3
Penumbra
(salvageable
brain area)2
Adapted from:
1. Saver J. Stroke 2006;37:263-266.
2. González RG. Am J Neuroradiol 2006;27:728-735.
3. Donnan G, Davis S. Lancet 2002;1:417-425.
Ischaemic core
(brain tissue
destined to die)2
اسلاید 16 :
The area of infarct represents severe ischaemia2
1. Saver J. Stroke 2006;37:263-266.
2. Moustafa RR, Baron JC. Br J Pharmacol 2008;153:S44-S54.
Every second counts1
Thrombolysis needs to be given as early as possible to prevent the conversion of potentially viable brain tissue in the penumbra from becoming completely ischaemic and dying
Cerebral blood flow pattern after middle cerebral artery occlusion
6 hours after stroke onset
Infarct
Penumbra
اسلاید 17 :
The area of infarct represents severe ischaemia2
1. Saver J. Stroke 2006;37:263-266.
2. Moustafa RR, Baron JC. Br J Pharmacol 2008;153:S44-S54.
Every second counts1
Thrombolysis needs to be given as early as possible to prevent the conversion of potentially viable brain tissue in the penumbra from becoming completely ischaemic and dying
Cerebral blood flow pattern after middle cerebral artery occlusion
24 hours after stroke onset
Infarct
Penumbra
اسلاید 18 :
Areas of ischaemia following middle cerebral artery occlusion before (left) and after (right) reperfusion
Time is Brain Tissue1
An untreated patient loses approximately 1.9 million neurons every minute in the ischaemic area1
Reperfusion offers the potential to reduce the extent of ischaemic injury3
Penumbra
(salvageable
brain area)2
Adapted from:
1. Saver J. Stroke 2006;37:263-266.
2. González RG. Am J Neuroradiol 2006;27:728-735.
3. Donnan G, Davis S. Lancet 2002;1:417-425.
Ischaemic core
(brain tissue
destined to die)2
اسلاید 19 :
علائم هرسكته مغزي بسته به قسمت درگيرشده متفاوت است سايرعلائم ممكن است به شرح زير مشاهده شود:
1- همي پارزي
2- همي پلژي
3- آتاكسي
4- آفازي ، ديزآرتري
5- ديسفاژي
6- پارستزي
7- ديپلوپي وتاري ديد
نكات قابل توجه !!!
اسلاید 20 :
8- سردردشديدوناگهاني
9- ازدست دادن حافظه كوتاه مدت وطولاني مدت
10- سرگيجه بدون دليل وسقوط ناگهاني
11- بي اختياري ادرارومدفوع
12- اشكال درپيداكردن كلمات وفهم آنها
13- عدم توانايي درانجام حركات ظريف
