I. PERSONAL DATA II.

Name: Edwin Ruiz Sex: Female Address: Tallungan, Reina, Mercedez Birth date: July 26, 1960 Birth place: Luna, Isabella Age: 49y/o Occupation: House Keeper Religion: Roman Catholic Civil Status: Widow Nationality: Filipino II. HISTORY OF PAST ILLNESS The daughter of the patient reported that the patient already hasdiabetes and hypertension during her 30s and has no other sickness otherthan those. Visual problems were also verbalized by the patient. Also, thedaughter verbalized of no surgery was done to the patient. III. HISTORY OF PRESENT ILLNESS Prior to admission, patient is having a slurred speech and an elevatedblood pressure. According to her daughter, the patient suddenly fell from herseat and speech became incomprehensive, hand and feet movementsbecame imprecise. Patient was then admitted in General Faustino M. Dy, Sr, MemorialHospital by her attending physician, Dr. Paguirigan, at exactly 08:50 in theafternoon of July 7, 2009. She was admitted with the admitting diagnosis ofCVA probable infarct vs. hemorrhage.

IV. BRIEF DESCRIPTION OF THE DISEASE Cerebrovascular Accident Definition: It is characterized by a relatively abrupt onset of persistingneurological symptoms due to the destruction of brain tissue (infarction)cause by ischemia (thrombus or embolism) or hemorrhage resulting fromdisorders in blood vessels that supply the brain. Also called stroke Stroke any sudden onset focal neurological deficit Causes: Intracerebral hemmorhage (rupture of a blood vessel in the pia mater or brain Emboli (blood clots) Atherosclerosis (formation of plaque) of the cerebral arteries. Risk Factor: 1.Hypertension leading risk factor for coronary heart disease and stroke treatable and can be controlled.

2.Modifiable by change in lifestyle a. smoking b.elevated serum cholesterol c. obesity d. heart disease 3.Modifiable by Medical mean a.Transient Ischemic Attack b.Asymptomatic carotid bruit c. Diabetes Mellitus d.Increased blood viscosity e. HPN 4.Non modifiable risk factors a. age b. sex c. race d.previous stroke Types of Stroke by Etilogy: 1.Hemorrhage stroke (intracranial hemorrhage) 5% of all strokes two division a.Intracerebral (10%) due to rupture of weakened vessels within brain parenchyma as result of Hypertension, arteriovenous malformation or tumor Page2 of53 b.Subarachnoid (5%) result from aneurismal rupture of acerebral artery with blood loss into space surrounding thebrain; evolve over 1 2 hours. 2.Ischemic Strokes (remaining 85%) Large (40%) or small (20%) vessel thrombosis -most commonly occur in presence of atherosclerotic cerebrovascular disease -vascular changes or lipohyalinosis found in small deep penetratingarteries as associated with chronic hypertension can lead to smallvessel thrombosis. -rapid or prolonged interval of onset and may lead last many hours Cerebral embolism (20%) -usually a cardiac origin -frequently result of chronic ischemic cardiovascular disease withsecondary ventricular wall hypokinessis or artial arrhythmia bothconditions increase risk of intracardiac thrombus formation -quick onset and fully develop in a matter of minutes Temporal Classification of Stroke

1. Transient ischemic attack (TIA) neurologic symptoms develop and disappear over several minutes and completely resolve in 24 hours most frequently associated with atherosclerotic carotid artery disease 2. Reversible Ischemic Neurologic Deficit etiology unknown likely the result from small infarctions (Lacunes) of the deep subcortical gray and white matter resulting in only temporary impairment 3. Stroke in Evolution describe an unstable ischemic event characterized by the progressive development of more severe neurologic impairment often associated with active occlusive thrombosis of a major cerebral artery. Once stable called Complete Stroke Most important sign Intellectual Regression