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Acute Imaging for Evidence-Based Treatment of Ischemic Stroke

Table of Contents

Introduction.

Pathophysiology.

Diagnostics.

Pharmacological treatment

Conclusion.

References.

Introduction to Ischemic Stroke Treatment

With the scenario and as per Isabella’s health condition, there are certain risk factors associated here, since the patient as per the analysis from the emergency department had gone through the ischemic stroke. In this context, certain risk factors about ischemic stroke involve high blood pressure with diabetes, a higher level of cholesterol along the poor functioning of the brain where there occur malformations of arteriovenous which is very common for the elderly patients like Isabella (Barlinn, 2017,p.508). The other risk factors that might be considered in this context is the age. Since the lady is very aged, along with the stroke problem, there also presents some other problems like breathing problems. From her past, it has been found that the lady had certain other health issues like smoking, osteoporosis, diabetes along with rheumatoid arthritis those which can be considered as some of the driving factors behind the ischemic stroke of the patient (Fukuta, 2017,p.1887).

The possible signs and symptoms of Isabella might occur in the future which involves an increase in the thirst along with the frequent urination and increased hunger since the patient had already been diagnosed with diabetes what her past medical history reflects. These things lead to certain future problems like strokes like an ischemic stroke which is actually, Isabella is going through now. In the real-life, there exists a link between ischemic stroke and diabetes. A person having diabetes like Isabella develops certain pathologic changes within the blood vessels in different locations which leads to stroke where the cerebral vessels get directly affected. In this situation, the possible signs which the patients get suffered from are the higher mortality rates and the glucose eels also become very high (Thomalla & Gerloff, 2019,p.526). Again there also exists a link between hypertension and ischemic stroke where due to the weakening of the blood vessels, they are more likely to get blocked which ultimately creates ischemic stroke.

Pathophysiology

The pathophysiology of stroke can be defined as an outcome of the ischemic stroke which is complex and at the same time also involves different processes like a failure of energy, an increased amount of the intracellular level of calcium along with the generation of the arachidonic acid products. Along with this, an increased amount of intracellular calcium levels is also present (Fukuta, 2017,p.1880).

Diagnostics

The first step to determine the ischemic stroke or the hemorrhagic stroke is through a CT scan or MRI of the head. However, according to Weisenburger-Lile (2019,p.115), MRI will be in this case turns out to be better as compared to the CT scan since, through MRI, the clearer images get produced through the magnetic resonance imaging. In this situation, the doctors can be able to view the position and the functioning of the soft tissues like that of the torn ligaments along with the herniated discs.

As per (), MRI can be defined as a test that generally produces good pictures of the brain and the arteries and this test is looking for the presence of abnormalities in the brain and the blood vessels. It also helps in determining how that particular area of the bran got damaged by an ischemic stroke (Weisenburger-Lile, 2019,p.117). The doctors mainly perform an MRI test to check how the brain is responding to such loud music at the time of the examination of the patient. The test takes around 30 to 90 minutes to get completed.

In doing this, a high dosage intravenous injections are given to the patient to check certain areas in the brain that how they have got affected and hence side by side looking for the solutions regarding how to make proper treatment or the patient. “Each enrolling center was free to use its routine CT or MRI stroke protocol, and no attempt was made to standardize imaging acquisition. As per protocol requirement, all examinations included at least brain and intracranial vessel imaging, with either CT angiography (CTA) or MR angiography (Zhang, 2018,p.178)”.

Pharmacological Treatment

The medications that have been provided to the patient is basically to treat the diabetes of the patient along with the maintenance of the cholesterol level in the patient. These need to be figured out first that whether the patient was taking these dosages properly or not since ischemic stroke is linked with diabetes of the patient who has not undergone proper treatment. There is no defined treatment to cure the stroke of the patient. However certain factors that lead the patient towards stroke are the higher level of bold sugars and the hypertensions which need to be cured first (Weisenburger-Lile, 2019,p.116). This can be stated as one form of the pharmacological treatment for acute ischemic stroke patients like Isabella.

As per the research findings, it can be stated that the Intravenous administration of the alteplase can be defined as one of the approved medical therapy to treat patients with acute ischemic stroke. This kind of medication is only applicable to the patient within 2 hours after the onset of the symptoms for the faster recovery of the patient. The recommended dosage for this is around 0.9 mg. Since t is an intravenous process, certain problems and the contradictions are associated with this like the internal or the external bleeding especially in the arterial and the venous puncture sites (Maier, 2017,p.75). In addition to this, the risk of thromboembolism can also occur along with cholesterol embolization. The other side effects of this medication are nausea, mild fever, dizziness, etc.

Conclusion on Ischemic Stroke Treatment

The main findings that have been obtained from the case scenario are that there exists no particular treatment for the ischemic stroke order to prevent the stroke, certain things need to be kept under control that is the diabetic rate of the patent along with the control of hypertension. Along with the other things that need to be looked for is the age factor of the patient and hence treating the patient like that way that is the painless treatment wherever possible.

References for Ischemic Stroke Treatment

Barlinn, J. (2017). Acute endovascular treatment delivery to ischemic stroke patients transferred within a telestroke network: a retrospective observational study. International Journal of Stroke, 12(5), 502-509. doi:https://doi.org/10.1177%2F1747493016681018

Belt, G. H. (2016). In-transit telemedicine speeds ischemic stroke treatment: preliminary results. Stroke, 47(9), 2413-2415. doi:https://doi.org/10.1161/STROKEAHA.116.014270

Fukuta, T. (2017). Combination therapy with liposomal neuroprotectants and tissue plasminogen activator for treatment of ischemic stroke. The FASEB Journal, 31(5), 1879-1890. doi:https://doi.org/10.1096/fj.201601209R

Maier, B. (2017). Mortality and disability according to baseline blood pressure in acute ischemic stroke patients treated by thrombectomy: a collaborative pooled analysis. Journal of the American Heart Association, 6(10), 64-84. doi:https://doi.org/10.1161/JAHA.117.006484

Sternberg, Z. (2020). Central noradrenergic agonists in the treatment of ischemic stroke—An overview. Translational stroke research, 11(2), 165-184. doi:https://doi.org/10.1007/s12975-019-00718-7

Thomalla, G., & Gerloff, C. (2019). Acute imaging for evidence-based treatment of ischemic stroke. Current opinion in neurology, 32(4), 521-529. doi:10.1097/WCO.0000000000000716

Weisenburger-Lile, D. (2019). Direct admission versus secondary transfer for acute stroke patients treated with intravenous thrombolysis and thrombectomy: insights from the endovascular treatment in ischemic stroke registry. Cerebrovascular Diseases, 47(3-4), 112-120. doi:https://doi.org/10.1159/000499112

Zhang, F. (2018). Vinpocetine inhibits NF-κB-dependent inflammation in acute ischemic stroke patients. Translational stroke research, 9(2), 174-184. doi:https://doi.org/10.1007/s12975-017-0549-z

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