stroke

Question 1

outcome of a stroke (blood clot in cerebral artery)

Answer 1

death of brain tissue due to hypoxia
no local cerebral blood flow resulting in tissue infarction

Question 2

what is a transient ischaemic attack (TIA)

Answer 2

temporary ischaemia of one of the brain vessels
sees rapid deterioration (facie drooping, speech difficulty, arm weakness) but all is regained within 24 hrs (usually within 30mins)
risk of a full stroke in future

Question 3

what is thought to be the cause of a TIA

Answer 3

platelet embolisms blocking artery which are quickly washed away by circulation

Question 4

risk factors for a stroke

Answer 4

smoking
hypertension
ischaemic heart disease
alcohol
atrial fibrillation
diabetes mellitus
oral contraceptive pill
thrombophillia

Question 5

what are the 2 different types of stroke

Answer 5

ischaemic (85%)
haemmorhage (10%)

Question 6

acronym for stroke symptoms

Answer 6

F - facial drooping
A - arm weakness
S - speech difficulties
T - time, how long has it been going on for

Question 7

causes of haemmhorage strokes

Answer 7

intracranial bleed e.g ruptured aneurysm
embolism from LHS heart

Question 8

primary prevention of strokes

Answer 8

stop smoking, control hypertension, well controlled diabetes
(reducing risk factors)

Question 9

secondary prevention of strokes

Answer 9

after a stroke
anti platelet medications - aspirin , clopidogrel
surgery - carotid endarterectomy to remove atheromas

Question 10

investigating a potential stroke

Answer 10

need to identify if it is a stroke and if so whether it is ischaemic or heammorhage or a sub arachnoid haemmorhage
CT scan - good for identifying haemmhorage, easy access but not good for ischaemic strokes
MRI scan - less readily available but good for identifying ischaemic strokes

Question 11

complications if a stoke is survived

Answer 11

motor function loss - swallowing, walking, dysphonia
sensory loss - e.g CN V damage - no facial sensation
Cognitive impairment - memory loss, processing difficulties, emotional changes

Question 12

Dental Aspects of a stroke patient

Answer 12

impaired mobility and dexterity - poor OHI , less attendance
communication difficulties - dysphonia, cognitive difficulties
increased risk of cardiac emergencies
possible risk of loss of protective reflexes - e.g aspiration of food and saliva if dysphagia