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1-Vascular causes:-
A)-Thrombotic:-
C)- Haemorrhagic:
1-Intracerebral
2-Subarachnoid
3-Subdural or extradural
The causes of intracranial
haemorrhage are:
1-Hypertension:
1-Paralysis of one
sideof the body.
2-Hypertonia (spasticity) of the paralysed
muscles of clasp-knife type:
6-Gait :
According to the site of the lesion
3-Cerebral
2-Brain stem
1-Spinal
1-Spinal Cord
At the level of
the lesion
Below the
Touch level of
lesion
2-Brain stem
2-Pontine lesions
1-Mid-brain lesion M.L.B
Weber
Benedict
Millard-Gubler
3-Medullary lesions
3- Cerebral
1- Cortical
2- Subcorical
3- Capsular
MANAGEMENT OF HEMIPLEGIA
1-GENERAL:
. Care of the skin:
. Care of respiration:
.Care of nutrition and fluid balance:
.Care of the urinary bladder:
. Care of the bowels:
Symptomatic Treatment
1.Cerebral dehydrating
2.Antiemetics
4.Muscle relaxents
5.Vitamins and tonics .
3- Physiotherapy
1- Proper positioning of the hemipegic side.
2-Passive,active assited,active exercises.
. To minimize contractures
. To strength muscles
3-Antispastic methods to control spasticity.
4-Gait and balance training.
4- Specific Treatment
1)- Cerebral Thrombosis:
A-Care of Blood Pressure
* Hypotensive drugs---------if B.P is above 200/120.
Capotril--------25to50 t.d.s
* Vasopressor drugs-----------if B.P is very low.
B- Anti platelates:
*Aspirin: single dose 75-300mg daily
*Persantin:75 mg twice daily
* Ticlopidine:250 mg twice daily
C- Anticoagulants: used in all cases
Indications:
Contraindications:
Method :
* Heparin
* Antidote :-
D- Other drugs may be used:
1- Nootropil :
2- Trental :
3- Trivastal :
4- Cerebral Vasodilators :
B-Cerebral Embolism :
c- Cerebral Haemorrhage :
D- Cerebral Inflammation:
E- Brain Tumors :
1- Surgical removal.
2- Deep X-rays therapy.
Thank you