1. 1 | P a g e Dr. O.P.VermaM.B.B.S.,M.R.S.H.(London)President, Flax Awareness Society7-B-43, Mahaveer Nagar III, Kota (Raj.)Visit us at http://flaxindia.blogspot.com09460816360- = 140 ../5.5 , = 167 ../6.5 , = 93../3.6 1300-1400 85% 100 - 41%, 22%, 19% 18% 18.6 , (Dominant Hemisphere) 750-1000 .. , 46 cm3 6% - (White Matter) - (Grey Matter) 4 6 , 416 .. 10 2% 20% 25 70,000 0.25% ?

2. 2 | P a g e - - - 3-4 , - - - 45 ( 700,000) 60 15 59 2-3 - 30-50% 29 NINDS , 30% FAST ?FAST .... (Mnemonic) 1998

3. 3 | P a g e FAST F = Facial weakness , ,A = Arm weakness ,S = Speech difficulty , - T = Time to act 3 - - - Transient Ischemic Attack (TIA) , - 1- 80-85 (, ) ( Clot) , - ( ) ( Atria ) (Atrial Fibrillation) ( ) , 2- - , - (Aneurysms) Arteriovenous Malformation - , -

4. 4 | P a g e - - - , , ( ) - - ( ) (vasospasm) TIA 55 - , ( ) 115/75 mm Hg - , , , -, 200 mg/dL , , - (heart failure), , , (abnormal heart rhythm) Transient ischemic attack (TIA) , ( 24 ) - , ( ) (TIA) , TIA (Spasm) ... 35% , 50% ...

5. 5 | P a g e , , , , () , - , - MCA StrokeMCA - , - (Hemianopsia) , (dominant hemisphere) - ( Nondominant hemisphere) , MCA - , - ACA ACA , , -, (altered mental status), , ACA - , - , - (urinary incontinence)

6. 6 | P a g e - PCA StrokePCA Stroke - ( hemianopsia) , - , ( visual agnosia), ( altered mental status), -, - - , ( Nystagmus), ( Diplopia), (Dysphagia), - (Dysarthria), - (Facial hypesthesia), (Syncope), - (Visual field deficits), (Ataxia) - , 2-20 - ( Motor Symptoms) - , , - - - ,, , - - (Hemiplegia) - ( Hemiparesis) - - - - , (dysphagia dysarthria) (ataxia) (Sensory) , , , , , , (paresthesia) , - -

7. 7 | P a g e , (Speech, Language andCommunication disabilities) 25% , , (aphasia) , (dysarthria) , ( Cognitive, Thought andMemory Problems) , , , , , - ( Emotional Disturbances) , , , , , , , , , - ,, , , (Tumor) , , (TIA) - -

8. 8 | P a g e - - -(Complete Blood Cell Count) - , , , - (Blood Chemistry Panel) - , ,, (BT, CT, PT, PTT, Fibrinogen etc.) () - - , , , ..., , - .. .. .. ... .. ... (Time Window) , ... .. .. ... .. (CTA) .. .. , - , - - - - - (TEE) ,

9. 9 | P a g e - - (MRI) ... ... ... (MRA) , - rTPA - - - rTPA TIME LOST = BRAIN LOSTTIME = BRAIN , , -

10. 10 | P a g e , , .., , .. , Penumbra ( ) - 18 - , SPO2 92% - - - 10 25 45 60 ... 3 - ( ) - ((rrTTPPAA)) ( ) , - , 50 40,000 - -

11. 11 | P a g e 24 ... 18 14 .... = 0.9 / ( 90 ) 10% 60 - 90% 325 , , , , , (Aravon) - 2001 (ROS) Inflamation ( ) - .. 24 30 .. 14 , , (Cognition) 24 1000-2000 , , , , ( ) , ,

12. 12 | P a g e - , , , .... 24 SBP 185 DBP 110-139 10 .. 1-2 5-10 10-20 10 20 .. 150 .. 140 0.5-10 mg/kg/minute - , (rTPA) - - ... - , - - ,

13. 13 | P a g e , , ( ) - (AVM) - , ( ) - ( ) LDL 100 mg/dl , , , , , , , , -