(^250) Medical-Surgical Nursing Demystified
the patient the best chance for recovery without permanent disability. Patients
withhemorrhagic stroke may need surgery to relieve intracranial pressure or stop
the bleeding. A large area of damage may lead to significant permanent disability
or death.
HALLMARK SIGNS AND SYMPTOMS
- Mental impairment
- Disorientation, confusion
- Emotional changes, personality changes
- Aphasia (difficulty with speech; may be receptive, expressive)
- Slurring of words
- Sensory changes (paresthesia, visual changes, hearing changes)
- Unilateral numbness or weakness in face or limbs
- Seizure
- Severe headache due to increased intracranial pressure from hemorrhage
- TIA symptoms are similar but have a shorter duration and resolve
INTERPRETING TEST RESULTS
- CT scan identifies area of bleeding (usually for emergency use).
- MRI (magnetic resonance imaging) identifies location of ischemic areas
(slower than CT scan). - MRA (magnetic resonance angiography) can identify abnormal vasculature
or vasospasm. - Diffusion/perfusion MRI or MRA will show areas that are not getting ade-
quate blood supply, but have not yet suffered an infarction. - SPECT (single photon emission computed tomography) will show an area
that is not perfusing adequately
TREATMENT
It is most important to determine whether the patient has suffered an ischemic or
hemorrhagic stroke as the treatment is different. Giving a thrombolytic agent to the
patient who has had a hemorrhagic stroke will only cause further bleeding into