Stroke Flashcards
What is meant by the term Stroke?
Stroke is defined as a disruption of blood flow to the brain.
What are the 2 types of stroke?
Ischemic and Hemorrhagic
What occurs during a Ischaemic Stroke?
During a Ischaemic stroke blood vessels in the brain, spinal cord or eye gets blocked or narrowed, causing lack of blood flow leading to cell damage and death.
What occurs during Haemorrhagic Stroke?
During Haemorrhagic Strokes blood vessels rupture leading to bleed intracerebrally or subarachnoidally resulting in brain tissue injury and direct toxic effects from the blood
What 5 non-modifiable risk factors can lead to Stroke?
Age
Genetic predisposition
Gender
Ischaemic heart disease
Sickle cell disease
What are the 6 modifiable risk factors that can lead to stroke?
HT
Smoking
Diabetes
AF
Hyperlipidaemia
Diet, alcohol and exercise
What 6 symptoms are present during a Stroke?
Facial drooping
Arm weakness
Speech difficulty
Dizziness
Loss of consciousness
Headache
What common scan is used to differentiate between the type of Stroke?
CT scans are used to differentiate between the type of stroke where a Ischaemic stroke would show up with darker parts indicating cell death and a haemorrhagic stroke would present with brighter patches indicating bleeding.
What are the first line drugs used in the management of acute Ischaemic Stroke?
Aspirin
Alteplase ( if within 4.5 hours of onset)
PPI (Hx - dyspepsia)
How are patients with Haemmorrhagic Stroke initially managed ?
Any patients receiving anticoagulant therapy need to be reversed.
Vit K Antagonist - IV Vit K and Prothrombin complex concentrate.
DOACs - idarucizumab or 4-factor prothrombin complex
What drugs are used in the secondary prevention of Ischaemic Stroke?
Antiplatelet therapy:
Clopidogrel
MR Dipyridamole
Aspirin
Ticagrelor
Statins
Antihypertensives (if required)
If the patient has both Ischaemic Stroke associated with AF what secondary prevention is used?
Anticoagulants such as warfarin, direct thrombin, factor Xa inhibitors.
