ACKNOWLEDGEMENT

I would like to express my special thanks of gratitude to my

teacher Miss . K . Seethala Devi as well as our
principle shri . N.Swaminathan who gave me the
golden opportunity to do this wonderful project on the topic
STROKE , which also helped me in doing a lot of research
and I also came to know about so many new things and I extend
my sincere thanks to DR. Arul selvam who helped me
to complete the project successfully and I am really thankful to
them.secondly I would also like to thank my parents and friends
who helped me a lot in finalizing this project within the limited
time frame .

1
Content
CERTIFICATE
ACKNOLEDGEMENT
INTRODUCTION
TYPES OF CANCER
CAUSE OF CANCER
SYMPTOMS OF CANCER
DIAGONIS
TREATMENT
CANCER CAUSING AGENTS
PRECAUTION
ANALYSIS OS CANCER IN INDIA
REFERENCE
INTRODUCTION
stroke is a "brain attack". It can happen to anyone at any time. It occurs when
blood flow to an area of brain is cut off. When this happens, brain cells are
deprived of oxygen and begin to die. When brain cells die during a stroke,
abilities controlled by that area of the brain such as memory and muscle control
are lost.

How a person is affected by their stroke depends on where the stroke occurs in
the brain and how much the brain is damaged. For example, someone who had a
small stroke may only have minor problems such as temporary weakness of an
arm or leg. People who have larger strokes may be permanently paralyzed on
one side of their body or lose their ability to speak. Some people recover
completely from strokes, but more than 2/3 of survivors will have some type of
disability.

Stroke is a medical condition in which poor blood flow to the brain results in
cell death. A stroke occurs when a blood vessel that carries oxygen and
nutrients to the brain is either blocked by a clot or bursts (or ruptures). When
that happens , part of the brain cannot get the blood (and oxygen) it needs, so it
and brain cells die.
TYPES OF BRAIN
SROKES
1. Ischemic
2. Hemorrhagic
 ISCHEMIC :
Stroke can be caused either by a clot obstructing the flow of blood to
the brain is called an ischemic stroke . In an ischemic stroke, blood
supply to part of the brain is decreased, leading to dysfunction of the
brain tissue in that area. There are four reasons why this might
happen: 1.Thrombosis (obstruction of a blood vessel by a blood clot forming
locally)2.Embolism (obstruction due to an embolus from elsewhere in the body,
see below),3Systemic hypoperfusion (general decrease in blood supply, e.g., in
shock4.cerebral venous sinus

tthrombosis HEMORRHAGI
.

C:
Hemorrhagic strokes are less common, in fact only 15 percent of all
strokes are hemorrhagic, but they are responsible for about 40 percent
of all stroke deaths.A hemorrhagic stroke is either a brain aneurysm
burst or a weakened blood vessel leak. Blood spills into or around the
brain and creates swelling and pressure, damaging cells and tissue in
the brain. There are two types of hemorrhagic stroke called
intracerebal and subarachnoid.There are two main types of hemorrhagic
stroke:

 Cerebral hemorrhage (also known as intracerebral hemorrhage), which is

basically bleeding within the brain itself (when an artery in the brain
bursts, flooding the surrounding tissue with blood), due to either
intraparenchymal hemorrhage (bleeding within the brain tissue) or
intraventricular hemorrhage
 Subarachnoid hemorrhage, which is basically bleeding that occurs outside
of the brain tissue but still within the skull, and precisely between the
arachnoid mater and pia mater

CAUSE OF BRAIN
STROKE
The different forms of stroke have different specific causes.

Causes of ischemic stroke

Ischemic stroke is the most common form, accounting for around 85 percent of
strokes. This type of stroke is caused by blockages or narrowing of the arteries
that provide blood to the brain, resulting in ischemia - severely reduced blood
flow that damages brain cells.These blockages are often caused by blood clots,
which can form either in the arteries within the brain, or in other blood vessels
in the body before being swept through the bloodstream and into narrower
arteries within the brain. Fatty deposits within the arteries called plaque can
cause clots that result in ischemia.

Causes of hemorrhagic stroke

Hemorrhagic strokes are caused by arteries in the brain either leaking blood or
bursting open. The leaked blood puts pressure on brain cells and damages them.
It also reduces the blood supply reaching the brain tissue after the hemorrhage
point. Blood vessels can burst and spill blood within the brain or near the
surface of the brain, sending blood into the space between the brain and the
skull.The ruptures can be caused by conditions such as hypertension, trauma,
blood-thinning medications, and aneurysms (weaknesses in blood vessel
walls).Intracerebral hemorrhage is the most common type of hemorrhagic stroke
and occurs when brain tissue is flooded with blood after an artery in the brain
bursts. Subarachnoid hemorrhage is the second type of hemorrhagic stroke and
is less common. In this type of stroke, bleeding occurs in an artery in
subarachnoid space - the area between the brain and the thin tissues that cover

it.

SYMPTOMS OF STROKE :
Strokes occur quickly, so symptoms often appear suddenly and without
warning.

The main symptoms of stroke are:

 Confusion - including trouble with speaking and understanding.

 Headache - possibly with altered consciousness or vomiting.
 Numbness or inability to move parts of the face, arm, or leg -
particularly on one side of the body.
 Trouble seeing - in one or both eyes.
 Trouble walking - including dizziness and lack of co-ordination.

Strokes can lead to long-term problems. Depending on how quickly it is

diagnosed and treated, the patient can experience temporary or permanent
disabilities in the aftermath of a stroke. In addition to the persistence of the
problems listed above, patients may also experience the following:

 bladder or bowel control problems

 depression
 pain in the hands and feet that gets worse with movement and
temperature changes
 paralysis or weakness on one or both sides of the body
 trouble controlling or expressing emotions

Symptoms vary among patients and may range in severity.

The acronym F.A.S.T. is a way to remember the signs of stroke, and can help
identify the onset of stroke more quickly:

 Face drooping - if the person tries to smile does one side of the face
droop?
 Arm weakness - if the person tries to raise both their arms does one arm
drift downward?
 Speech difficulty - if the person tries to repeat a simple phrase is their
speech slurred or strange?
 Time to call 911 - if any of these signs are observed, contact the
emergency services.

The faster a person with suspected stroke receives medical attention, the better
their prognosis and the less likely they will be to experience lasting damage or
death.
HOW IS A STROKE
DIAGONISED?
Signs of a stroke require immediate medical attention.

Strokes happen fast and will often occur before an individual can be seen by a
doctor for a proper diagnosis.

For a stroke patient to get the best diagnosis and treatment possible, they should
be treated at a hospital within 3 hours of their symptoms first appearing.

Ischemic strokes and hemorrhagic strokes require different kinds of treatment.

Unfortunately, it is only possible to be sure of what type of stroke someone has

had by giving them a brain scan in a hospital environment.

There are several different types of diagnostic tests that doctors can use to
determine which type of stroke has occurred:
 Physical examination - a doctor will ask about the patient's symptoms
and medical history. They may check blood pressure, listen to the carotid
arteries in the neck, and examine the blood vessels at the back of the eyes,
all to check for indications of clotting.
 Blood tests - a doctor may perform blood tests to find out how quickly
the patient's blood clots, the levels of particular substances (including
clotting factors) in the blood, and whether or not the patient has an
infection.
 CT scan - a series of X-rays that can show hemorrhages, strokes, tumors,
and other conditions within the brain.
 MRI scan - radio waves and magnets create an image of the brain to
detect damaged brain tissue.
 Carotid ultrasound - an ultrasound scan to check the blood flow in the
carotid arteries and to see if there is any plaque present.
 Cerebral angiogram - dyes are injected into the brain's blood vessels to
make them visible under X-ray, to give a detailed view of the brain and
neck blood vessels.
 Echocardiogram - a detailed image of the heart is created to check for
any sources of clots that could have traveled to the brain to cause a
stroke.
TREATMENT OF STROKE
As the ischemic and hemorrhagic strokes are caused by different factors, both
require different forms of treatment. It is not only important that the type of
stroke is diagnosed quickly to reduce the damage done to the brain, but also
because treatment suitable for one kind of stroke can be harmful to someone
who has had a different kind.

How is ischemic stroke treated?

Ischemic strokes are caused by arteries being blocked or narrowed, and so

treatment focuses on restoring an adequate flow of blood to the brain.

Treatment can begin with drugs to break down clots and prevent others
from forming. Aspirin can be given, as can an injection of a tissue
plasminogen activator (TPA). TPA is very effective at dissolving clots but
needs to be injected within 4.5 hours of stroke symptoms starting.

Emergency procedures include administering TPA directly into an artery in the

brain or using a catheter to physically remove the clot. Recent studies have
questioned the effectiveness of these methods, and so research is still ongoing as
to how beneficial these procedures are.

There are other procedures that can be carried out to decrease the risk of strokes
or TIAs. A carotid endarterectomy involves a surgeon opening the carotid artery
and removing any plaque that might be blocking it.

Alternatively, an angioplasty involves a surgeon inflating a small balloon in a

narrowed artery via catheter and then inserting a stent (a mesh tube) into the
opening to prevent the artery from narrowing again.

How is hemorrhagic stroke treated?

Hemorrhagic strokes are caused by bleeding into the brain, so treatment focuses
on controlling the bleeding and reducing the pressure on the brain.

Treatment can begin with drugs given to reduce the pressure in the brain,
control overall blood pressure, prevent seizures and prevent sudden
constrictions of blood vessels. If the patient is taking blood-thinning anti-
coagulants or an anti-platelet medication like Warfarin or Clopidogrel, they can
be given drugs to counter the medication's effects or blood transfusions to make
up for blood loss.

Surgery can be used to repair any problems with blood vessels that have led or
could lead to hemorrhagic strokes. Surgeons can place small clamps at the base
of aneurysms or fill them with detachable coils to stop blood flow and prevent
rupture.

If the hemorrhage was caused by arteriovenous malformations (AVMs), surgery

can also be used to remove small them if they are not too big and not too deep
within the brain. AVMs are tangled connections between arteries and veins that
are weaker and burst more easily than other normal blood vessels.

MEDICINES AND TREATMENT OF STROKE

REHABILITATION
Strokes are life-changing events that can affect a person both physically and
emotionally, temporarily or permanently. After a stroke, successful recovery will
often involve specific rehabilitative activities such as:

 Speech therapy - to help with problems producing or understanding speech.

Practice, relaxation, and changing communication style, using gestures or different
tones for example, all help.

 Physical therapy - to help a person relearn movement and co-ordination. It is

important to get out and about, even if it is difficult at first.

 Occupational therapy - to help a person to improve their ability to carry out

routine daily activities, such as bathing, cooking, dressing, eating, reading, and
writing.
 Joining a support group - to help with common mental health problems such as
depression that can occur after a stroke. Many find it useful to share common
experiences and exchange information.
 Support from friends and family - to provide practical support and comfort.
Letting friends and family know what can be done to help is very important.
Rehabilitation is an important and long part of treatment. With the right
help,rehabilitation to a normal quality of life is poss ible, depending on the severity of
thestroke.
Preventing a
stroke
The best way to prevent a stroke is to address the underlying causes. This is best done
by living healthfully, which means:

 Eating a healthy diet.

 Maintaining a healthy weight.
 Exercise regularly.
 Don't smoke.
 Avoiding alcohol or drink moderately.Eating a healthful diet means plenty of
fruits, vegetables, and healthy whole grains, nuts, seeds, and legumes; eating
little or no red or processed meat; limiting intake of cholesterol and saturated
fat (typically found in foods of animal origin); and minimizing salt intake so as
to support healthy blood pressure.Other measures taken to help reduce the risk
of stroke include:

 Keeping blood pressure under control.

 Managing diabetes.
 Treating obstructive sleep apnea (if present).As well as these lifestyle changes,
a doctor can help to reduce the risk of future ischemic strokes through
prescribing anti-coagulant and/or anti-platelet medication. In addition to this,
the arterial surgery previously mentioned can also be used to lower the risk of
repeat strokes, as well as some other surgical options still being studied.
PATIENTANNALYSIS
REPORT
UNIT -- Neurology

PATIENT NAME – Mr ChandraBabu k

AGE -- 45 Years

GENDER – Male

CONSULTANT – Dr. v.l Arulselvan,MD,DM [NEURO]

DIAGONIS -- Acute left hemisphere infaract with left ICA occlusion

DURATION OF STROKE – 3 years [2010 – 12]

CAUSE OF STROKE – Hypertension , Smoking for 20 years, 1 pack/day, Ethanol 4-5

day/week,180ml/day.

TYPE OF STROKE -- Ischemic

PATIENT CURRENT CONDITION -- Cured

TREATMENT (Taken by patient) :

PHYSICAL ACTIVITY – Physiotherapy , speechtherapy

MEDICATION NAME –Tab. Deplatt – 75, Tab.rosuvas – 40mg

DIET – Low salt diet

CONDITION AT DISCHARGE :
*ALERT
*SPEECH BETTER
*MEMORY IMPROVING
*MOVES ALL 4 LIMB
*WALK WITHOUT SUPPORT
Conclusion :
The onset of stroke is a dramatic and discouraging event both
for the person having the stroke and their family. A person may go
from complete independence to complete dependence in a matter of
minutes. Upon entering the medical system, patients are confronted
with a bewildering array of tests, people, and places, as well as
confusion about treatment and services.

Medical care for stroke survivors is often fragmented and

inconsistent. In some cases the patient is moved quickly from the
acute hospital to a skilled nursing facility or an inpatient rehab
department for rehabilitation. In urban areas, care may be more
comprehensive and organized, but in many other areas followup care
can be hit or miss.

Advances in acute treatment are saving the lives of people who would
not have survived in the past. As a result, post stroke therapy is more
important than ever. Yet access to services and inconsistencies in
healthcare professional knowledge about how the brain heals after a
stroke mean only a small percentage of stroke survivors are able to
access the latest information, equipment, and techniques.

Nursing and rehabilitation professionals play a critical role in the care

of the person with a stroke. We all play a role in improving outcomes
through education, training, and knowledge about the physical and
psychological effects of stroke. It is our responsibility to become
familiar with the roles and responsibilities of each profession involved
with post stroke care, as well to keep up with the astounding advances
in the emergency, acute, and long-term treatment of people who have
had a stroke.
Reference :
Websites refered

Google

Wikipedia

Stroke association .org

Neurology . com
Persons refered
Dr . Arul selvam
Patient : Mr .chandra babu k
Done by
P . Mirudhula