1. Neurologic Emergencies
Nelia B. Perez RN, MSN
PCU- MJCN
BSN 2012

2. CEREBROVASCULAR DISORDERS
An umbrella term that refers to
any functional abnormality of
the central nervous system that
occurs when the normal blood
supply to the brain is disrupted.

5. STROKE
a sudden neurological
event which results in
the new onset of
neurological symptoms.

6. TYPES of
STROKE

8. ISCHEMIC
STROKE
“BRAIN ATTACK”

24. MOTOR LOSS
-disturbance of voluntary motor
control on the side of the body
opposite the location of the
stroke lesion
•Hemiplegia
•Hemiparesis

25. COMMUNICATION LOSS
•Dysarthria
•Apraxia
•Agnosia
•Dysphasia or Aphasia

28. PERCEPTUAL DISTURBANCES
•Homonymous Hemianopsia
•Disturbance in Visual-Spatial Relations
- Unilateral Neglect
•Loss of Peripheral Vision
•Night Blindness
•Diplopia
•Horner’s Syndrome

34. SENSORY LOSS
•Slight Impairment of Touch
•Loss of Proprioception
•Difficulty in interpreting
visual, tactile, and auditory stimuli

35. COGNITIVE IMPAIRMENT &
PSYCHOLOGICAL EFFECTS
Memory Loss Emotional Lability
Poor Comprehension Hostility
Limited Attention Span Frustration
Forgetfulness Resentment
Lack of Motivation Lack of Cooperation
Depression

36. ASSESSMENT & DIAGNOSTICS
•Patient History
•Complete Physical and Neurologic Examination
•Initial Assessment: Airway Patency, Cardiovascular
Status, Gross Neurologic Losses
•Stroke Time Course Classification

37. STROKE TIME COURSE CLASSIFICATION
Stage 1: Transient Ischemic Attack
Stage 2: Reversible Ischemic Neurologic Deficits
Stage 3: Stroke in Evolution
Stage 4: Completed Stroke

38. DIAGNOSTIC TESTS
•CT Scan
•12-Lead ECG
•Carotid ultrasound
•Cerebral Angiography
•Transcranial Doppler Flow Studies
•Transthoracic or Transesophageal Echocardiography
•MRI of the brain and/or neck
•Xenon CT
•Single Photon Emission CT

47. MEDICAL MANAGEMENT
1. Treatment of TIA from atrial fibrillation or
suspected embolic or thrombotic causes
2. Thrombolytic Therapy for Ischemic Stroke
3. Therapy for Patients with Ischemic Stroke NOT
Receiving Thrombolytic Therapy
4. Managing Potential Complications

49. SURGICAL MANAGEMENT
CAROTID ENDARTERECTOMY
- Main surgical procedure for the management of TIAs
and small stroke
- Indicated for patients with symptoms of TIA or mild
stroke found to be due to carotid stenosis
- Complications: stroke, cranial nerve
injuries, infection, hematoma at the incision
site, carotid artery disruption

53. NURSING MANAGEMENT
•Improving Mobility and Preventing Joint Deformities
•Managing Sensory-Perceptual Difficulties
•Attaining Bowel and Bladder Control
•Improving Thought Processes
•Improving Communication
•Maintaining Skin Integrity
•Improving Family Coping
•Helping the Patient Cope with Sexual Dysfunction

56. HEMMORHAGIC
STROKE
CEREBRAL ANEURYSM
SUBARACHNOID HEMORRHAGE