Hemiplegia Commonly Asked Questions - All Explained

What do you understand by the term 'stroke'?
Stroke is characterized by rapidly progressive clinical symptoms and signs of focal, and at times global, loss of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin.

What are the causes of hemiplegia?
About 80% of all strokes are due to cerebral infarction resulting from thrombotic or embolic occlusion of a cerebral artery . The remaining 20% are caused by either intracerebral or subarachnoid haemorrhage.
Elderly:
· Vascular event (thrombosis, embolism or haemorrhage).
· Tumour.
· Subdural haematoma.
· Syphilis.

Youth:
· Multiple sclerosis.
· Tumour.
· Trauma.
· Embolism (look for underlying valvular heart disease, atrial fibrillation).
· Connective tissue disorder.
· Neurosyphilis.
· lntracranial infection: look for underlying acquired immune deficiency syndrome
(AIDS), otitis media, cyanotic heart disease.

What is the role of anticoagulants in the immediate treatment of acute ischaemic stroke?
Anticoagulants (including unfractionated heparin, low molecular weight heparin or specific thrombin inhibitors) offer no short- or long-term benefits in the immediate treatment of acute ischaemic stroke. Although the risks of deep venous thrombosis or pulmonary embolus are significantly reduced, these benefits are offset by a dose-dependent increased risk of intracranial or extracranial bleeding.

What is the prognosis in a patient with acute ischaemic stroke?
About 10% of' these patients will die within a month from the onset of the stroke . Of those who survive the acute event, about half will experience some disability after 6 months.

What are the risk factors for stroke?
Hypertension, ischaemic heart disease, atrial fibrillation, peripheral vascular disease. diabetes, smoking, previous TIA, cervical bruit, hyperlipidaemia, raised haematocrit, oral contraceptive pill, cardiomyopathy.

What do you understand by the term 'RIND'?
Reversible ischaemic neurological disease, in which symptoms and signs reverse within 1 week but not within 24 hours.