Sunday, March 24, 2013

Handling In Stroke

Handling In Stroke
Treatment of stroke patients are specifically given to the type of strokenya, namely ischemic and haemorrhagic stroke.
Ischemic Stroke

Principles of management of ischemic stroke is to limit the infarction area by increasing blood perfusion to the brain, to treat disease that causes stroke and prevent brain udema. In the management of a special nature, it is usually a doctor trying to suggest some drug therapies that act. These drugs are as follows:
  • Drug antitrombolitik R-tPA and urokinase were administered intravenously. This medicine works to destroy the thrombus-vein thrombosis in the brain. This drug works to prevent thrombus that will narrow the vessel lumen.
  • An anticoagulant drug that works to prevent blood clots and thrombus embolization, such as heparin, coumarin, oral dicomarol. The drug is primarily given to stroke patients who have cardiac abnormalities. Drug side effects can occur thrombocytopenia can cause bleeding so it should count the number of platelets control was performed daily.
  • Drugs that serves as neuroproteksi or protect the brain organ that inhibit the excessive influx of calcium into brain cells.
  • Glutamate antagonists that work on the glutamate receptor glycine binding.
  • Drugs to prevent damage to brain cell membranes.

Haemorrhagic stroke

In patients with haemorrhagic stroke conservative therapy drug therapy and surgery. The purpose of surgery is to remove, stop and prevent bleeding that occurs in the blood vessels of the brain. Surgery is done during the first 24-48 hours of stage 1 and 2. Surgery will be postponed in the event of vasospasm (shrinking) blood vessels causes brain surgery will further aggravate the patient's condition.

Conservative therapy includes:

- Conduct intensive care
- Maintain vital functions (breathing, and circulation)
- Providing sedation and pain relief
- Bed rest or tirang lying or resting in bed
- Therapy udema brain
- Antihypertensive Therapy
- Treatment of ischemic neurological deficit due to vasospasm
- Antifibrinolisis and
- Rehabilitation
- Speech therapy
- Physiotherapy
- Psychotherapy

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