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Management of hemiplegia

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Management of hemiplegia

  1. 1. MANAGEMENT OF PATIENTS WITH HEMIPLEGIA
  2. 2. AIMS Minimising the volume of brain that is irreversibly damaged. Preventing complications. Reducing patient`s disability and handicap through rehabilitation. Reducing the risk of r/c episodes.
  3. 3. MANAGEMENT Supportive care Thrombolysis Aspirin & Heparin Management of risk factors Carotid endarterectomy & Angioplasty
  4. 4. SUPPORTIVE CARE Early admission Dysphagia-early bedside test of swallowing Nasogastric tube or IV Distinguish patients with neuro deficits & those suffering from hypoxia,sepsis,epilepsy
  5. 5. Cerebellarhaematomas or infarcts Anti oedema agents Surgical compression to reduce ICT
  6. 6. THROMBOLYSIS rt-PA Given within 3 hrs of onset of symptoms Increases the risk of h`gic transformation of cerebral infarcts
  7. 7. ASPIRIN & HEPARIN Aspirinafter ischaemic stroke Reduces r/c Heparin-dec r/c & venous thromboembolism Risk of intracranial & extracranial h`age IC h`age excluded on brain imaging
  8. 8. MANAGEMENT OF RISK FACTORS Chances of r/c Pts of ischaemic stroke-antiplatelet drugs & statins Pts in AF-oral anticoagulants Ischaemic & h`gic strokes-BP reduction
  9. 9. CAROTID ENDARTERECTOMY & ANGIOPLASTY Pts with TIA-50% stenosis of carotid artery of same side of lesion Reduces risk of r/c More effective in first couple of weeks Angioplasty & stenting are more feasible but not superior to endarterectomy
  10. 10. MANAGEMENT OF ACUTE STROKE Airway Breathing Circulation Hydration Nutrition
  11. 11. Medication BP &blood glucose Temperature Pressure areas Incontinence
  12. 12. THANK YOU

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