Stroke Flashcards
What is a stroke?
Death of brain tissue from hypoxia
Infarction of tissue
What is a TIA?
Transient ischaemic attack
Temporary ischaemia
What are risk factors for stroke?
Hypertension
Smoking
Alcohol
Ischaemic heart disease
Atrial fibrillation
Diabetes mellitus
Describe the prevalence of stroke?
12% of all deaths
Commonest cause of adult disability
Lifetime risk 1 in 6
Affects males over females
What are common causes of stroke?
Intracranial bleed
Embolism from left side of heart
Atheroma of cerebral vessels
What are other causes of stroke?
Venous thrombosis
‘Borderzone’ infarction
Vasculitis
How can strokes be prevented?
Reduce risk factors
ANtiplatelet action
Carotid endarterectomy
Preventative neurosurgery
What investigations are used in strokes?
Need to differentiate infarction, bleed and subarachnoid haemorrhage
Imaging - CT scan, MRI, DSA
Assess risk factors eg - carotid ultrasound, ECG, blood pressure
What are the effects of stroke?
Loss of functional brain tissue
Gradual or rapid loss of function
Inflammation in tissue surrounding the infarct/bleed
What are the complications of stroke?
Motor function loss
Sensory loss
Dysphonia
Problems with swallowing
Pneumonia
Cognitive impairment
Memory impairment
Emotional lability and depression
How are strokes managed?
Acute phase - limit damage and reduce future risk
Chronic phase - rehabilitation and reduce future risk
What happens in the acute phase treatment of stroke?
Reduce damage
Improve blood flow/oxygenation
Normoglycaemia
Remove haematoma - subarachnoid haemorrhage only
Prevent future risk - 300mg aspirin daily, anticoagulation if indicated
What happens in chronic phase treatment of stroke?
Nursing and rehabilitation
Immobility support
Speech and language therapy
Occupational therapy
What are the dental aspects of stroke?
Impaired mobility and dexterity
Communication difficulties
Risk of cardiac emergencies
Loss of protective reflexes
Loss of sensory information
‘Stroke pain’ - CNS generated pain perception
