The Driver is Dead

A smart and active child was playing with a battery-operated toy car. It fell from his hands and stopped working. He took it to his father who was an engineer.

His father opened the car with a screwdriver to examine the trouble. The curious child was watching carefully. Suddenly he cried out in joy, "Daddy, I have found out why it doesn't work." He put his tiny fingers into the car's front seat and took out a dead fly. He declared aloud, "How can it work when the driver is dead?"

Actually, it was a wrong diagnosis. The father had found that the cells had been displaced by the fall. But he enjoyed the child's innocent comment. Later he repaired it and returned it to the child who resumed his play.

Whenever we encounter a failure or disaster in our life or career, we assign the responsibility to some other person. In some cases, the actual fault may be our own. But we attribute it to others or to 'ill-fate'.

Failures and negative incidents in life should be seen as part of God's plans for our ultimate welfare.

. God has definite and specific plans about every man.

"The Lord says I alone know the plans I have for you, plans to bring you prosperity and not disaster, plans to bring about the future you hope for" {Jeremiah 29: 11}.

what is Cerebrovascular accident

Cerebrovascular

(CVA), also known as a stroke, is an acute neurologic injury whereby the blood supply to a part of the brain is interrupted, either by a clot in the artery or if the artery bursts. The result is that the part of the brain perfused by that artery no longer can receive oxygen carried by the blood and it dies (becomes necrotic) with cessation of function from that part of the brain. In addition to tissue death, hemorrhages also cause damage from physical impingement of blood on the brain tissue. Stroke is a medical emergency and can cause permanent neurologic damage or even death if not promptly diagnosed and treated. It is the third leading cause of death and adult disability in the US and industrialized European nations.

Risk factors
Risk factors include advanced age, hypertension (high blood pressure), diabetes mellitus, high cholesterol, and cigarette smoking. Cigarette smoking is the most important modifiable risk factor of stroke.

Signs and symptoms
The symptoms of stroke depend on the type of stroke and the area of the brain affected. Ischemic strokes usually only affect regional areas of the brain perfused by the blocked artery. Hemorrhagic strokes can affect local areas, but often can also cause more global symptoms due to bleeding and increased intracranial pressure.

Treatment
Early assessment
It is important to identify a stroke as early as possible because patients who are treated earlier are more likely to survive and have better recoveries.
If a patient is suspected of having a stroke, emergency services should be contacted immediately. The patient should be transported to the nearest hospital that can provide a rapid evaluation and treatment with the latest available therapies targeted to the type of stroke. The faster these therapies are started for hemorrhagic and ischemic stroke, the chances for recovery from each type improves greatly. Quick decisions about medication and the need for surgery have been shown to improve outcome.
Only detailed physical examination and medical imaging provide information on the presence, type, and extent of stroke.
Studies show that patients treated in hospitals with a dedicated Stroke Team or Stroke Unit and a specialized care program for stroke patients have improved odds of recovery.

Pathophysiology

The ductus arteriosus is part of the normal fetal circulatory system. This vessel connects the aorta and the pulmonary artery. Prior to birth the ductus arteriosus allows for antegrade flow from the right ventricle to the aorta. Following birth the ductus arteriosus normally closes. If the ductus remains open, blood will shunt from the aorta into the pulmonary artery due to the decrease in pulmonary vascular resistance. The amount of left-to-right shunting depends upon the size of the PDA and the relative resistances of the systemic and pulmonary circulations. Left-to-right shunting of blood caused by patency of the ductus arteriosus results in increased pulmonary artery blood flow as well as left atrial and left ventricular overload. Extensive aortic runoff, with low aortic diastolic pressure secondary to a large patent ductus arteriosus can result in systemic organ hypoperfusion. Pulmonary vascular obstructive disease may occur, sometimes as early as one year of life.

In very rare instances, usually in the presence of other complex cardiovascular anomalies, there is a bilateral DA. In the typical left aortic arch, the aortic end of the DA arises distal to the left subclavian artery and the pulmonary end inserts at the junction of the main and left pulmonary arteries.