Essay About Ischemic Stroke, Essays (university) of Medicine

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ISCHEMIC STROKES

PIG

INTRODUCTION

BACKGROUND

Dyslipidemia is an increase in fat and cholesterol levels in the blood. In dyslipidemia, there is a decrease in HDL levels, an increase in total cholesterol and triglycerides. It is estimated that the Indonesian population affected by dyslipidemia is more than 15 years old. Factors that cause dyslipidemia are consumption of foods that are low in fiber and high in fat, consumption of foods that are difficult to control leading to obesity, unhealthy lifestyles, stress and smoking. One of the complications of dyslipidemia is stroke. Stroke is a cerebrovascular disease that causes disruption or damage to brain function associated with blood vessels that supply blood to the brain. According to the World Health Organization, a stroke occurs due to a disruption in the blood supply to the brain due to blocked blood vessels or ruptured blood vessels.Stroke is the fifth most common cause of death when considered separately from other cardiovascular diseases.Based on conditionsStrokes can be categorized as ischemic, hemorrhagic, or subarachnoid strokes. Ischemic stroke occurs when blood flow to the brain is blocked or blood vessels narrow due to blood clots. The risk factors for ischemic stroke itself can be divided into two, namely those that can be modified and those that cannot be modified. Stroke prevention can be done by controlling blood pressure caused by hypertension, DM (diabetes mellitus), dyslipidemia or hypercholesterolemia, and reducing smoking activity or quitting smoking, especially also in reducing salt intake and sugar intake as well as regular exercise and good stress management. , so that it can reduce stroke mortality and also the incidence of recurrent stroke.

RISK FACTORS

The risk factors for ischemic stroke itself can be divided into two, namely those that can be modified and those that cannot be modified. Modifiable or controllable risk factors:

1. Hypertension
2. Diabetes mellitus
3. Dyslipidemia
4. Lack of physical activity
5. Unhealthy diet
6. stress. Unmodifiable risk factors:
7. Genetics or family history
8. Age
9. Gender DIAGNOSIS To establish the diagnosis that the patient is having a stroke, anamnesis, physical examination and supporting examinations such as: Anamnesis : The main thing to ask the patient's family is
10. Initial symptoms
11. Patient activity during attack
12. Other symptoms such as headaches, nausea, vomiting, spinning sensation, seizures, hiccups (hiccup), visual disturbances, and decreased consciousness
13. Stroke risk factors (hypertension, diabetes, etc.). Physical examination :
14. Vital signs: found increased blood pressure
15. From neurological examination, inspection of the face is asymmetrical

3. On examination of muscle strength found left hemiplegia (loss of muscle ability to move that occurs on one side of the body)
4. Negative meningeal stimulation
5. pathological babinsky reflex -/+ was found Supporting examinations in the form of:
6. Ct-Scan :CT scan of the head is carried out within the first 24 hours since the patient was admitted to the hospital
7. MRIs:Diagnosis of acute stroke is made more quickly and accurately using MRI (higher resolution, appearance of abnormal images more quickly, and can assess lesions in the brainstem). Laboratory examination:
8. blood routine, blood sugar while, kidney function (urea and creatinine), activated partial thrombin time (APTT) and prothrombin time (PT)
9. While the patient is in the room, laboratory tests can be carried out such as fasting blood sugar and 2 hours postprandial, lipid profile, C-reactive protein (CRP), blood sedimentation rate, and examination for indications such as: cardiac enzymes (troponin / CKMB) and serum electrolytes GOVERNANCE a. Pharmacological therapy The goal of therapy in acute ischemic stroke is to preserve tissue in areas of decreased perfusion but sufficient to avoid infarction. The therapy that can be given is recombinant tissue-type plasminogen activator (rtPA) or alteplase. The AHA (American heart Association)/ASA (American Stroke Association) recommend intravenous (IV) alteplase for patients who meet inclusion criteria and have symptom onset or last known baseline within 3 hours. Alteplase IV dose of 0.9 mg/kg, with a maximum dose of 90 mg. The first 10% of the dose is given during the first minute as a bolus, and the remaining dose is given over the next 60 minutes. Then another therapy can be givenanticoagulants, administration of routine anticoagulants to acute ischemic stroke patients aims to improve neurological or as an early prevention of recurrent strokes. b. Non-pharmacological therapy

ischemic, hemorrhagic, or subarachnoid. The cause of ischemic stroke is due to a thrombotic or embolic event which causes a decrease in blood flow to the brain.The risk factors for ischemic stroke itself can be divided into two, namely modifiable and non-modifiable. Stroke prevention can be done by controlling blood pressure caused by hypertension, DM (diabetes mellitus), dyslipidemia or hypercholesterolemia, and reducing smoking activity or quitting smoking, especially also in reducing salt intake and sugar intake as well as regular exercise and good stress management. , so that it can reduce stroke mortality and also the incidence of recurrent stroke.