Stroke Flashcards
What is a Stroke?
Neurological dysfunction caused by the interruption of the blood supply to the brain, usually because a blood vessel is blocked by a clot or bursts
What is Ischaemic Stroke?
- Temporary neurologic dysfunction
- Blood clot stops the flow of blood (narrowing due to atherosclerosis) to an area of the brain
What is Haemorrhagic Stroke?
- Weakened/diseased blood vessels rupture
- Blood leaks into brain tissue
- Different types managed in different ways
What is the Facial Symptoms of Ischaemic Stroke caused by?
Patient may have FACIAL SYMPTOMS caused by narrowing of the vessels that are supplying to the brain. They have these transient episodes of ischaemic which result in the neurological dysfunction (manifested in facial expression) and then it resolves
RISK: a plaque ruptures, blood clot forms, brain becomes damaged due to ischaemia
What are the changing definitions of TIAs?
- ‘No acute infarction’ (permanent damage) is the best definition in practice but is limited by accessibility to more sophisticated imaging techniques
- Commonly Used Definition: Symptoms lasting less than 1 hour
Patients who have TIA are at very high risk of having what?
A stroke
What are the Signs and Symptoms of Stroke?
- Motor impairments (weakness and paralysis of parts of body including face)
- Sensory impairments (touch, pain, warm/cold)
- Slurred speech
- Vision difficulties
- Dizziness
- Sudden severe headache
- Difficulty swallowing
What is important in determining stroke treatment?
The time since onset of symptoms is important in determining stroke treatment > patients should seek medical advice quickly and note time of symptoms onset
The effects of a stroke depend on what?
Which part of the brain is injured and how severely it’s affected
How is severity of a stroke assessed?
There are scoring systems used to assess the severity of a stroke e.g. NIHSS
What factors influence the balance of benefit and risk in Ischaemic Stroke?
- Neurons die fairly quickly under ischaemic conditions and as a result, thrombolysis will only be of benefit if given relatively soon after the onset of symptoms
- Limit treatment to less than 4.5hrs since onset
- After 4.5hrs, neurons are likely to be sufficiently damaged that thrombolysis is unlikely to prevent any further damage, but the bleeding risk of using a thrombolytic remains
- Limit treatment to less than 4.5hrs since onset
- Warfarin/DOACs and Heparin increase the risk of bleeding with thrombolytic
What are the Aims of Multidisciplinary Teams in Terms of Stroke Rehabilitation?
- Improve function and/or prevent deterioration of function
- Bring about highest level of independence
- Maximise self-determination
- Aid reintegration of person into community
What Specialised Teams of Health Professionals are used in Terms of Stroke Rehabilitation?
- Physio (recovery of sensor, motor function and functional mobility)
- OT (optimise participation and independence)
- Speech Pathology (Communication and swallowing)
- Dieticians (Diet modification with swallowing difficulties)
- Social Workers
What are the Risk Factors for Stroke?
- TIA
- Diabetes
- Increased alcohol intake
- AF
- Other heart disease
- Carotid artery stenosis
- HTN
- Hyperlipidaemia
- Tobacco smoking
What is the Difference between Primary and Secondary Stroke Prevention?
- Primary Prevention: Treatment to prevent a person suffering their first stroke/TIA
- Secondary Prevention: Treatment to prevent person from having another stroke/TIA
