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Management of dysphagia after stroke - Case Study Example

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In the cases of dysphagia and dysarthria during and after stroke, the patient observes difficulties regarding swallowing, sleeping, writing and speaking. It is observed by number of physicians that the patient's speech also may worsen during the period. They generally slur and mumble words…
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Management of dysphagia after stroke
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Download file to see previous pages The appetite will be decreased. They feel depressed and it will be expressed on their faces. (Tyler Reimschisel, MD, 2002) 1
In the two pairs of vessels that supply blood to the brain, they deliver 20 percent of cardiac output. These are observed joined on the ventral surface of the brain and are called as intracranial vessels. It was observed that the isolated infarction of the anterior cerebral artery is uncommon. The highest risk of recurrence of the stroke occurs within the first month after the initial stroke or symptoms. This compels the physicians to evaluate the patients presenting with TIA or suspected stroke. The prophylactic therapy begins immediately at presentation. In the patients with recent cerebral ischemia, the first step is to localise the lesion. The evaluation of heart, extracranial carotid arteries and intracranial circulation strokes is necessary for the patients who undergo recent stroke. The extracranial carotid circulation and the intracranial anterior circulation can be observed using MRA and CTA.( National guideline clearing house, 2007)2 Subcortical infarctions or lacunae are observed in a diameter greater than 1.5 cm. they are thromboembolic in nature. (Scott E. Kasner, MD; Lewis B. Morgenstern, MD, 2005)3
The American Heart Association endorsed stroke rehabilitation guidel...
The level I evidences recommend that the delivery of post stroke care is multidisciplinary rehabilitation. Evaluation of swallowing can be a screen for dysphagia, recognising that impairment may cause in severe pneumonia and death. The guidelines also call for standardised assessment that tailor complete treatment procedure.( Harold P. Adams, Jr, MD, 2003) 4
This should be patient specific addressing his needs and medical therapy for depression and emotions. The goal of rehabilitation will be to prevent complications and minimise the impairments. This is possible by maximising the functional activities of the organs. The multidisciplinary rehabilitation will be undertaken by a multidisciplinary team that contain physician, nurse, physical therapist, occupational therapist, kinesiotherapist, speech and language pathologist, psychologist, recreational therapist, patient and family members of care givers. The team should educate the family and care givers before the process of rehabilitation initiates. The patient specific recommendations should be based on clinical problems or resources unique to the medical system. 5
According to a study the bilateral pallidal surgery can be highly effective in case of primary dystonia. In case of DYT-1 patients with primary dystonia and with the patients with negative with DYt-1, the pallidal surgery is recommended. The gene positive patients have improved their condition by 90 to 100 percent to the burke fahn Mrsden dystonia. In case of secondary patients a 30 percent improvement has been observed. A self resolving sysarthria has been observed in the case of a patient after the surgery. The less response in the ...Download file to see next pages Read More
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