CVA/Stroke And Compartment Syndrome Essay
The paper “CVA/Stroke And Compartment Syndrome” is an exceptional example of an essay on nursing.
Due to limited clinically verified information on stroke and Ischemic attack or what’s referred to as a “mini-stroke”, Flora E. van Leeuwen, Ph.D., and colleagues from the Department of Epidemiology at the Netherlands Cancer Institute carried out a study among 2,201 Hodgkin lymphoma survivors, where they found out that most surviving patients had been treated between 1965 and 1995 and survived for at least 5 years from the time they were diagnosed. They used their findings to compare the incident rates between clinically verified stroke and TIA as well as rates from the general population. (National Cancer Institute, 2014).
Their findings further identified that 96 patients later developed the cerebrovascular disease after a follow up of almost 18 years with the incidence of stroke at 2.2 times the incidence in the general population and 3.1 for TIA. Generally, they concluded that there were still higher risks for the patients treated with radiation therapy. With increased risk associated with neck and mediastinum radiation. (National Cancer Institute, 2014).
Compartment syndrome (CS) most commonly results from a vascular injury in the brachial artery which may not be treated promptly. A study was carried out on 139 patients with traumatic brachial artery injury from 1985 to 2009, to determine the risk factors that lead to the development of CS. The study prompted compartmental pressure monitoring, advent of intraoperative arteriography, early fasciotomy, concomitant vein repair, brachial arterial repair as well as postoperative anticoagulation which concluded that the improvement was a success.
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The study further found out that, sustained Compartment Syndrome can result from irreversible functional impairment, ischemia, and contracture. Therefore the diagnosis of CS should be based on the presence of swollen and tense compartment and the basic classic “p’s”, pain, pulselessness, pallor, paresthesia and paralysis. (Kim, et al., 2009). During the study 139 patients were divided into 2 cohorts, 29 were identified with upper extreme CS and put into the CS cohort and the other 110 into NCS cohort. From the results, the study concluded that there is a direct relationship between time of intervention, functional deficit, combined nerve injuries, intraoperative blood loss and the high rate of permanent disability as a result of traumatic brachial artery injuries. Therefore frequent examination of the upper extremity compartments must be conducted and considerations made to prophylactic fasciotomies so as to help reduce long-term functional deficits. (Kim, et al., 2009)
Compartment syndrome occurs when excessive pressure builds up inside an enclosed muscle space in the body. Compartment syndrome usually results from bleeding or swelling after an injury. The dangerously high pressure in compartment syndrome impedes the flow of blood to and from the affected tissues. It can be an emergency, requiring surgery to prevent permanent injury.
What Happens in Compartment Syndrome?
Groups of organs or muscles are organized into areas called compartments. Strong webs of connective tissue called fascia form the walls of these compartments.
After an injury, blood or edema (fluid resulting from inflammation or injury) may accumulate in the compartment. The tough walls of fascia cannot easily expand, and compartment pressure rises, preventing adequate blood flow to tissues inside the compartment. Severe tissue damage can result, with loss of body function or even death.
The legs, arms, and abdomen are most prone to developing compartment syndrome. CVA/Stroke And Compartment Syndrome Essay .
Compartment Syndrome Causes
Acute compartment syndrome is the most common type of compartment syndrome. About three-quarters of the time, acute compartment syndrome is caused by a broken leg or arm. Acute compartment syndrome develops rapidly over hours or days.
Compartment syndrome can develop from the fracture itself, due to pressure from bleeding and edema. Or compartment syndrome may occur later, as a result of treatment for the fracture (such as surgery or casting).
Acute compartment syndrome can also occur after injuries without bone fractures, including:
Taking anabolic steroids can also contribute to developing compartment syndrome.
Another form of compartment syndrome, called chronic compartment syndrome, develops over days or weeks. Also called exertional compartment syndrome, it may be caused by regular, vigorous exercise. The lower leg, buttock, or thigh is usually involved. CVA/Stroke And Compartment Syndrome Essay .
Abdominal compartment syndrome almost always develops after a severe injury, surgery, or during critical illness. Some conditions associated with abdominal compartment syndrome include:
- Trauma, especially when it results in shock
- Abdominal surgery, particularly liver transplant
- Burns
- Sepsis (an infection causing inflammation throughout the body)
- Severe ascites or abdominal bleeding
- Pelvic fracture
- Vigorous eccentric abdominal exercises (i.e. situps on a back extension machine in weight rooms)
As the pressure in the abdominal compartment rises, blood flow to and from the abdominal organs is reduced. The liver, bowels, kidneys, and other organs may be injured or permanently damaged. CVA/Stroke And Compartment Syndrome Essay.