1.

Acute Iscemic Stroke

2. Demographic Data of the Patient
Name
Age
Sex
Religion
Marital Status
Occupation
Source of Health Care
Date of Admission
Provisional Diagnosis
Date of Surgery (if any)
3. Medical History Past and Present Illness
4. Comparison of the Patient’s Disease with Book Picture.
a) Anatomy and Physiology.
b) Etiology.
c) Pathophysiology.
d) Signs and Symptoms.
Stroke Warning Signs :
1) Sudden numbness or weakness of the face, arm or leg, especially on one side of the
body.
2) Sudden confusion, trouble speaking or understanding.
3) Sudden trouble seeing in one or both eyes.
4) Sudden trouble walking, dizziness, loss of balance coordination.
5) Sudden severe headache with no known cause.
(AHHA, 2018)
e) Diagnosis-Provisional & Final
1) Risk for ineffective cerebral tissue perfusion related with hypertension disease.
2) Deficite self care related with weakness extremities
3) Impaired physical mobility related with weakness of extremities
4) Risk for unstable blood glucose level related with average daily physical activity is less
than recommended for gender, age and nonadherence to diabetes management plan.
5) Overweight related to disordered eating behavior
6) Anxiety
f) Investigation
Investigation of acute stroke
1) Haematological investigations
Serum protein levels, plasma viscosity and electrophoresis may be of use if
hyperviscosity is suspected, usually the ESR is high in these patients.
Autoantibody screen in younger patients or in patients with suspected autoimmune
disease or vasculitis.
Sickle test in appropriate racial groups (Negroes).
Haemostatic profile in patients with haemorrhagic stroke not due to hypertension,
aneurysm or arteriovenous malformation, tests of haemostasis including prothrombin
time, activated partial thromboplastic time, thrombin time, bleeding time or fibrin
degradation products may be required.
 2) Urine tests
Screening for homocystinuria with methionine loading, or tests for porphyria or
metanephrines to detect phaeochromocytoma may be sometimes indicated.
3) Lumbarpuncture
This investigation may occasionally be helpful by excluding lesions mimicking stroke,
such as meningitis, encephalitis, or to confirm subarachnoid haemorrhage.
4) Computed tomography ofthe brain
CT scanning is very informative in stroke for several reasons. In the few patients for
whom a clear history of a sudden onset offocal neurological deficit cannot be obtained,
it differentiates 'stroke' from 'non-stroke' lesions.
5) Diagnosis ofcardiac sources ofemboli and echocardiography
Two-dimensional echocardiography is now widely available. This non-invasive
investigation is relatively simple to perform and may identify a potential cardioembolic
cause of ischaemic stroke.
6) Cerebral angiography in patients with stroke
Present indications for angiography in the acute phase of ischaemic stroke are limited
to the diagnosis of non-atherogenic cerebral vessel occlusion such as that caused by
carotid artery dissection, Moya Moya disease or vasculitis, or ischaemic stroke in a
young patient with no obvious causative factors.
Angiography may be indicated in patients who have made a good recovery from a mild
ischaemic stroke, ifcarotid endarterectomy to prevent further stroke is being
considered.
g) Compilcation and Prognosis