Cerebrovascular Stroke

Diagnosis:

hypertension- hemiplegia- slurred speech- altered consciousness or coma

CT scan: brain edema

Management:

you must: 1-lower blood pressure 2- lower brain edema 3- increase brain stimulation 4- inhibit stress ulcer

1-Lower blood pressure: by Lasix ampule 40 mg /12 hour intravenous until blood pressure is about 100/70 not less

                                                 
Or Epilat capsule sublingual after puncture of the capsule by a pin

2-Lower brain edema: by

1- Manitol 20% solution over one hour for first 2 days

2- By Dexamethazone ampule intravenous/12 hour for first 2 days then once daily for 2 days then stop

3-Brain stimulation: by 2 ampule Nootropil intravenous /8 hours

4-Inhibit stress ulcer: by Zantac ampule /12 hours

Or Zantac tablet /12 hours

 NB
      - Manitol is osmotic diuretic.

      - If hypertension + renal colic: use Epilat from the start.

      - If hypertension + DM (dehydration) : use Epilat instead of Lasix.

      - Lasix = Furosemide = Salex.

      -Nootropil = Stimulan = Piracetam : is a brain stimulant and protect cerebral cortex from hypoxia.