Stroke Flashcards
what is stroke
acute focal neurological deficit resulting from cerebrovascular disease and lasting more than 24hrs or causing earlier death
what are the 2 types of stroke
infarction of tissue, haemorrhage into the brain tissue
what is a transient ischaemia attack (TIA)
rapid loss of function but rapid recovery
what is the acronym to spot a stroke
FAST
what does FAST stand for
facial drooping, arm weakness, speech difficulty
why do TIAs occur
due to platelet emboli from vessels in neck blocking the blood flow to tissue causing ischaemia, these are then rapidly removed
what risk comes with having a TIA
greater risk of proper stroke
what are the main risks for stroke
hypertension, smoking, alcohol, ischaemic heart disease, atrial fibrillation, diabetes mellitus
what are the common causes of stroke
ischaemic stroke, intracranial bleed, embolic stroke, atheroma of cerebral vessels
what causes an intracranial bleed
aneurysm rupture
how do you prevent a stroke
reduce risk factors, antiplatelets, anticoagulants, carotid endarterectomy (removal of carotid artery/removal of plaque), preventative neurosurgery
what antiplatelets are used for stroke
aspirin, clopidogrel, dipyridamole
what anticoagulants are used for stroke
warfarin and apixaban
when deciding if a stroke is occurring, what do you need to differentiate between?
infarct, bleed and subarachnoid haemorrhage
what investigations are used for stroke
CT scan, MRI scan (sometimes), digital subtraction angiography
assessing risk factors
how do you assess risk factors for stroke
carotid ultrasound, cardiac ultrasound, ECG, blood pressure, diabetes screen, thrombophilia screen
what is the effect of stroke on the brain
loss of functional brain tissue
gradual or rapid loss of function
inflammation in tissue surrounding infarct/bleed
what are the complications of stroke
motor function loss, sensory loss and cognitive impairment
what does the cognitive impairment aspect of stroke affect
appreciation, processing of information, memory, emotions, speech and language
what is the acute phase of managing stroke aiming for
limiting damage to penumbra and reducing future risk
what is the chronic phase of managing stroke aiming for
rehabilitation and reducing future risk
how do you limit damage to the penumbra
calcium channel blockers (nimodipine)
improve blood flow/oxygenation
normoglycaemia
remove haematoma
why is brain glucose level important
as the brain is dependent on glucose for energy so it is not available there will be more damage
what drugs are used to prevent future risk of of stroke
aspirin 300mg daily
anticoagulation if indicated
what is included in chronic phase treatment for stroke
immobility support, speech and language therapy, occupational therapy
what are the dental aspects of stroke
impaired mobility
communication difficulties
risk of cardiac emergencies
loss of protective reflexes
loss of sensory information
stroke pain
