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1. MANAGEMENT OF
PATIENTS
WITH HEMIPLEGIA

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. MANAGEMENT
Supportive care
Thrombolysis
Aspirin & Heparin
Management of risk factors
Carotid endarterectomy &
Angioplasty

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. Cerebellarhaematomas or infarcts
Anti oedema agents
Surgical compression to reduce
ICT

6. THROMBOLYSIS
rt-PA
Given within 3 hrs of onset of
symptoms
Increases the risk of h`gic
transformation of cerebral infarcts

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. 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. 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. MANAGEMENT OF ACUTE
STROKE
Airway
Breathing
Circulation
Hydration
Nutrition

11. Medication
BP &blood glucose
Temperature
Pressure areas
Incontinence

12. THANK YOU