Stroke

Question 1

What is a stroke?

Answer 1

A stroke is a brain attack. It happens when blood supply to the brain is cut off causing neurological necrosis.

Question 2

What are the implications of stroke as a health problem in the UK?

Answer 2

Stroke is a major health problem in the UK. Over 100,000 UK Strokes a year. 1 in 4 of those will die within a year and 1 in 2 will have permanent disability. There are over 400 children Strokes a year in the UK.

Question 3

What are the three types of Stroke?

Answer 3

Ischaemic Stroke
Hemorrhagic Stroke
Transient Ischaemic Attack (TIA)

Question 4

What is an Ischaemic Stroke?

Answer 4

85% of strokes are ischaemic. Caused by embolisation of a brain blood vessel decreasing the blood flow to brain causing cerebral infarction. This is normally due to thrombosis. Less common cause is atherosclerosis.

Question 5

What is a Hemorrhagic Stroke?

Answer 5

15% of strokes are hemorrhagic and they are generally more severe. A hemorrhagic stroke occurs when a brain blood vessel leaks or ruptures bleeding into the brain. This occurs as a result of a number of conditions affecting blood vessels. Hemorrhagic strokes are divided into Intracerebral and Subarachnoid.

Question 6

What is a Transient Ischaemic Attack (TIA)?

Answer 6

Transient Ischaemic Attack sometimes called a ‘ministroke’ is a temporary decrease in blood to the brain with associated symptoms. This can last from a few minutes up to 24 hours. (During first few hours TIA cannot be differentiated from a stroke and should be treated as stroke.)

Question 7

What is a Intracerebral Stroke (ICH)?

Answer 7

One of the two types of hemorrhagic Stroke. 10% of Strokes are ICH. Most devastating stroke occurs as a result of spontaneous blood vessel rupture blood will fill the brain itself.

Question 8

What is a Subarachnoid Stroke (SAH)?

Answer 8

One of the two types of Hemorrhagic Stroke. 5% of Strokes are SAH. SAH is a haemorrhage of a cerebral blood vessel that bleeds into the subarachnoid space.

Question 9

What are some Stroke Signs?

Answer 9

• Severe Headache/ Coma
• Complete paralysis on one side of body
• Focal neurological deficits including hearing, speech, vision
• Confusion/ impaired GCS
• Vomiting
• Ataxia
• Dysphagia
• focal seizure
• behavioural changes
• neck pain/ stiffness
• full body paralysis

Question 10

What are some lifestyle stroke risk factors?

Answer 10

• Overweight
• Physical Inactivity
• Binge Drinking
• Cocaine/ Meth use

Question 11

What are some medical stroke risk factors?

Answer 11

• Uncontrolled Hypertension
• Smoking
• High Cholesterol
• Diabetes
• Obstructive Sleep Apnea
• Cardiovascular Disease
• Family history of stroke

Question 12

Stroke Assessment and Management?

Answer 12

FAST test. If positive TC transfer with ATMIST
Note time of Onset
ABCD
May have A problems
Keys ops include:
GCS
Pulse
Sats
Resp Rate
Blood Pressure (May require IV bolus)
Blood Glucose (Hypo may mimic stroke)
Temp