HEMİPLEGİA Sensory Motor Cognitive Course Cerebro Vascular Event - Hemiplegia Dr. Öğr. Gör. Gülşah Kınalı

Cerebro Vascular Event Hemiplegia is a vascular syndrome which is characterized by neuromuscular dysfunction in one half of the body due to pathological changes in the cerebral circulation. SVO Inflammation due to decreased blood flow to brain tissue due to reasons such as SVO, tumor, arterial infarction, bacterial endocarditis!.... Hemiplegia is a finding, so the result!...

Risk factors Major Risks Age --- increases both risk and risk Hypertension, non - treatable Substance addiction Cardiac diseases (CAD) ** Risk in treatment Diabetes Transient Ischemic Attack

Know these diseases? Remember? Congestive heart failure Atrial fibrillation Sinus Syndrome Know these diseases? Remember?

Congestive Heart Failure

Atrillar Fibrillation

Sinus Arrhythmia

Anatomy and Etiology Clinical manifestations of CVO vary depending on whether the anterior or posterior circulation of the brain is affected. Anterior Circulatory Ischemia Posterior Circulatory Ischemia Hemiparazi - more than post ataxia Hemianestez Bilateral or hemianesthesia Monocular blindness Vertigo Facial numbness hemiparesis Lower facial weakness Dysarthria, dysphagia Aphasia Syncope and dizziness Headache Dizartri - less than post. Tinnitus Loss of visual field diplopia

Pathogenesis thrombolytic **** Embolitic ** Lakuner * initially creates TIAHemorajik***** ischemic Hemorrhagic

Clinical Findings of Vascular Lesions Middle cerebral artery Anterior Cerebral Artery Posterior cerebral artery Internal carotid artery Basillar artery Anterior superior cerebellar artery Anterior inferior cerebellar artery Vertebral artery

Prognosis Flask --- Spastic --- Normal Tonus Full paralysis - synergy - voluntary movements

Treatment Acute Care Conventional Method. Neurophysiological approaches

Complications Lower extremity Upper extremity General Medical

History of Neurological Approaches PNF: Diagonal and sipiral thought of active and passive patterns have emerged and developed over time. Stretching effect and resistant work are important. Brunstrom: Firstly, motor synergies are created by utilizing pathological reflexes. Used in sensory stimulation and repositioning. Bobath: To eliminate the spasticity is the primary use for this purpose. Sensory Integration- Ayres: It argues that sensory and perceptual impairment causes functional liming. Space, shape perception, dyspraksi, tactile, auditory language probe. And it works on vestibular disorder, it is used in business dealings.

AFTER STROKE TREATMENT There are some exciting approaches to the treatment of stroke (nine-plasmon activator) However, it should be noted that the most important approach is prevention of stroke!

Primary Protection Hyperlipidemia - Stanins Atrial fibralation - Warfarin Aspirin for myocardial infarction and other vascular conditions For carotid stenosis, carotid endorocytosis can be used as preventive surgery.

Secondary Protection The target is people who have had TIA. -antitrombolytic drugs, surgical methods and endovascular treatments. Angioplasty, stents etc oplast.

Emergency Approach in Stroke

Emergency Treatment - Stroke *Prevent loss of functionality of the penumbra area. Is the airway open? Is fever and blood pressure normal? Nasal mask if oxygen saturation is insufficient If the nasal mask is inadequate, should be intubated and provided with mechanical ventilator assistance

Surgical treatment in stroke In acute stroke, the surgical option may not be chosen very quickly, because the sudden correction of blood flow may increase the damage. Carotid endorectomy Endovasicular ring if torn vein Closure may be required for aneurysms with stable neurological status, and open brain surgery for unstable patients.