Stroke Flashcards
Stroke
Sudden death of brain cells due to lack of oxygen and nutrients
Types of stroke
Ischaemic
Haemorrhagic
Ischaemic
Caused by blockage of blood flow to the brain
Thrombotic or embolic (travelled from somewhere)
Small vessel disease, large artery atherosclerosis, cardio-embolism stroke, cryptogenic (unknown)
Followed by TIA (mini stroke) <24hrs, no LT problems
85%
Haemorrhagic stroke
Caused by rupture of an artery in or to the brain
Intracerebral, subarachnoid
Symptoms: headache, nausea, vomiting, reduced consciousness, weakness in one part of the body
High mortality
Non-modifiable risk factors
Age Sex - men higher Race - African/Caribbean and SE/E Asia higher and more severe Family history Previous Ischaemic stroke or TIA
Modifiable risk factors
Hypertension, Diabetes
Coronary heart disease, Left ventricular hypertrophy, Asymptomatic carotid stenosis
XS alcohol, smoking, obesity
Fibrinogen, sickle cell disease, factor VIII
oxidative stress, lipoprotein
vWF, WBC count, C-reactive protein
Hormone replacement therapy, oral contraceptive
What is AF?
Atrial fibrillation - condition I which the atria beat irregularly instead of beating effectively to move blood into the ventricles
How does AF affect the risk for stroke?
Allows blood to slow down/poor, increasing the risk of stroke
Types of AF
Paroxysmal - episodes come and go, usually stop within 48hrs without treatment
Persistent - episode lasts longer than 7 days
Long-standing persistent - continuous for >1
Permanent - all the time
Treatment of AF
Medications to control heart rate and reduce risk or stroke
If no underlying cause:
1. Medicines to reduce risk of stroke
2. Medicines to control AF (beta blockers)
3. Cardio version
4. Catheter ablation
5. Pacemaker
Symptoms of stroke
Weakness/paralysis Numbness, tingling, decreased sensation Vision changes Speech problems, swallowing difficulty Loss of memory Loss of balance/coordination Personality and mood changes Vertigo Drowsiness, lethargy, unconscious Uncontrolled eye movements or eyelid dropping
How to diagnose stroke
Physical examination with medical history
Neurological examination
Radiological examination (CT or MRI)
Monitor for signs and ,ymptoms
What to monitor for if right cerebral hemisphere is location?
Visual and spatial awareness
Proprioception
What to monitor if left hemisphere is suspected?
Language
Analytical thinking
Math skill
What is the outcome of stroke dictated by?
Location
Size of brain damage
Presence of other medical conditions
Possibility of stroke recurring
