1 / 26

Hemiplegia

Hemiplegia. Hemiplegia Definition : paralysis of one side of the body due to pyramidal tract lesion at any point from its origin in the cerebral cortex down to the 5 th cervical segment. Causes :- 1-Vascular causes:- A)-Thrombotic :- 1-Vessels wall diseases. 2-Blood diseases.

alanna
Download Presentation

Hemiplegia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hemiplegia

  2. Hemiplegia Definition: paralysis of one side of the body due to pyramidal tract lesion at any point from its origin in the cerebral cortex down to the 5th cervical segment.

  3. Causes:- 1-Vascular causes:- A)-Thrombotic:- 1-Vessels wall diseases. 2-Blood diseases. 3-Circulation diseases.

  4. B) - Embolic : The source of embolus may be:- 1- Heart 2-Distal vessels 3-Rare sources: . *Lung *Bones C)- Haemorrhagic: 1-Intracerebral 2-Subarachnoid 3-Subdural or extradural

  5. The causes of intracranial haemorrhage are: • 1-Hypertension: 2-Rupture of an intracranial aneurysm angioma 3- Hemorrhagic blood diseases 4-Trauma to the head:

  6. 2-Infective: 3- Neoplastic: 4- Demyelinations: 5- Traumatic: 6- Congenital: 7- Hysterical:

  7. CLINICAL PICTURE Onset & Course: • -Acute onset & regressive course (vascular, infective & traumatic lesions). • -Gradual onset & progressive course (neoplastic lesions). • -Remittent & relapsing course (D.S.).

  8. Symptoms & Signs 1-Acute lesions: the clinical picture passes through 2 stages: • A)-Stage of flaccidity: due to neuronal shock. • B)-Stage of spasticity: this is the stage of established hemiplegia. • 2-Gradual lesions: the hemiplegia passes directly to the stage of spasticity.

  9. STAGE OF FLACCID PARALYSIS (SHOCK STAGE):-

  10. .STAGE OF SPASTTC. PARALYSIS: • 1-Paralysis of one sideofthe body.

  11. 2-Hypertonia (spasticity) of the paralysed muscles of clasp-knife type: 3-Exaggerated deep reflexes

  12. 4-Lost superficial reflexes: 5-Positive Babinski sign: 6-Gait :

  13. According to the site of the lesion 3-Cerebral 2-Brain stem 1-Spinal

  14. 1-Spinal Cord At the level of the lesion Pain&Tem Deep sensation Below the level of lesion Touch

  15. 2-Brain stem 2-Pontine lesions 1-Mid-brain lesion M.L.B Weber Benedict Millard-Gubler 3-Medullary lesions

  16. 3- Cerebral 1- Cortical 2- Subcorical 3- Capsular

  17. 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:

  18. Symptomatic Treatment 1.Cerebral dehydrating 2.Antiemetics 3.Tranquilizers and sedatives 4.Muscle relaxents 5.Vitamins and tonics .

  19. 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.

  20. 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

  21. C- Anticoagulants: used in all cases Indications: Contraindications:

  22. Method : * Heparin * Dindivan or Marcoumar: anticoagulants. - Monitor the dose using the prothrombin time. * Antidote :-

  23. D- Other drugs may be used: 1- Nootropil : 2- Trental : 3- Trivastal : 4- Cerebral Vasodilators :

  24. B-Cerebral Embolism : c- Cerebral Haemorrhage : D- Cerebral Inflammation:

  25. E- Brain Tumors : 1- Surgical removal. 2- Deep X-rays therapy.

  26. Thank you

More Related