Presentation is loading. Please wait.

Presentation is loading. Please wait.

ALTERATIONS IN THE NERVOUS SYSTEM

Similar presentations


Presentation on theme: "ALTERATIONS IN THE NERVOUS SYSTEM"— Presentation transcript:

1 ALTERATIONS IN THE NERVOUS SYSTEM
TREATMENT OF CVA

2 Cerebrovascular Accident Goals for Management
CT Scan – No hemorrhage: Consider Fibrinolytic therapy Check for exclusions tPA No anticoagulants or antiplatelet therapy for 24 hours If not a candidate: Antiplatelet Therapy CT Scan – Hemorrhage: Neurosurgery? If no surgery: Stroke Unit Monitor BP and treat Hypertension Monitor Neuro status Monitor blood glucose and treat as needed Supportive therapy

3 Thrombolytic Therapy IV (systemic) thrombolytic therapy
Retavase (rtPA) Eligibility criteria -no bleeding disorder -no recent surgeries -not on anticoagulants Intra-arterial thrombolysis pro-urokinase* *

4 Treatment for Ischemic Stroke
Thrombolytic Drugs: rtPA (recombinant tissue plasminogen activator) Retavase binds to thrombi fibrin causing fibrinolysis Enzymatic action digests fibrin & fibrinogen Results is clot lysis Administered within 3 hours of symptoms of ischemic CVA Confirmed DX with CT Patient anticoagulated ASA, Calcium Channel Blockers

5 Drug Therapy Thrombolytic therapy Anticoagulants
Lorazepam and other antiepileptic drugs Calcium channel blockers Stool softeners Analgesics for pain Antianxiety drugs

6 Medications Anticoagulants: to prevent further clot formation (heparin) Lorazepam and other antiepileptics: to prevent seizure activity Calcium channel blockers: to treat or prevent cerebral vasospasm(verapamil)

7 Medications Continued
Stool softeners: to prevent constipation Analgesics for pain Antianxiety drugs

8 CVA – Surgical Treatment
Carotid endarterectomy – preventive – > 100,000/year removal of atheromatous lesions Extracranial-intracranial bypass Clipping, wrapping, coiling aneurysm Treatment of AV Malformations

9

10 Hemorrhagic-Subarachnoid Cerebral Aneurysm – Surgical Tx

11 Hemorrhagic-Subarachnoid Cerebral Aneurysm – Coiling

12 Video of wire coils to treat aneuryms

13 Other Potential Measures
Cooling Ancrod Neuroprotective drugs


Download ppt "ALTERATIONS IN THE NERVOUS SYSTEM"

Similar presentations


Ads by Google