What is Stroke?
Stroke is defined as sudden onset of focal neurological deficit due to occulsion of blood supply or hemorrhage in the brain causing sign/symptoms lasting greater than 24 hours.
Types of Stroke
1) Ischemic Stroke
Congenital heart diseases
Occurs mostly in children
All Cardiac diseases
Ateriovenous malformation or due to any infection that may result in brain rupture
Causes of stroke in Children
Sinotic congenital heart disease
Soratic heart disease
3) Blood disorders
Sickle cell anemia
Protein C deficiency
Factor 5 deficiency
Antithrombin factor 3 deficiency
4) Vascular disorders
5) Drug induced stroke
6) Metabolic disorders
7) Other causes
Thrombus occulsion anterior,medial,posterior,basal vertebral and internl carotid artery.
Thrombosis most commonly occur at Atheromatous plaque and causes necrosis or stenosis of that wall.
1.Thrombus moves to distal region due to continous supply
2.There it Increases in size
3.Stop at any point according to condition
4.Causes ischemia of that point
Full term babies are at risk of stroke
Sign and Symptoms
Tendancy to use only one side of body
Trouble in walking,loss of coordination
Pain in face,slurred speech,sleepyness
Problem in seeing and sneezing,worst headache lasting for days without relief,new appearance of seizures on affected side of bod
Herpes simplex virus
Increase in Intracranial pressure
1) Within 48 hours of admission 1st line treatment is required.
2) Within 1st week of admission 2nd line treatment is required.
3) As per needed 3rd line treatment is required.
1st line treatment
Lab tests are needed in 1st line treatment
Lipid profile test
Plain chest X-ray
2nd line treatment
Transcranial and carotid doppler
Aminoacid lab test
Urine test for aminoacid
3rd line treatment
1.Differentiate btw Hemorrhagic and Ischemic stroke
2.Anticoagulants are contraindicated in hemorrhage
3.If stoke is caused by intracranial hemorrhage then manage it by
Give Steriod in balance amount
Shunt surgery if needed
- Prevent HTN and hyperglycemia because they can worse stroke
- If stroke is caused by HTN then manage it by: Antihypertensive drugsMaintain Fluid balancePrevent it from hyperglycemia6.
- If stroke is caused by Seizure then manage it by:AntibioticsAntiepilyptic drugs
- If stroke is caused by thrombus formation then manage it by:Antithrombin therapy(Heparin)
Oral anticoagulant agents(Warfarin) Thrombolytic agents(Streptokinase,urokinase)
Presentation of this topic is attached below: