stroke epidemiologu and presentation

Question 1

define a stroke

Answer 1

occurs when a blood vessel which is carrying O2 and nutrients to the brain bursts or is blocked by a clot

Question 2

define TIA

Answer 2

-transient ischemic attack
-mini stroke
-short blockage of blood flow - temporary
- resolves within 24 hours

Question 3

what are the 2 types of stroke?

Answer 3

-ischaemic
-haemorrhagic

Question 4

describe ischemic stroke

Answer 4

-area of infarction
-caused by blockage - thrombus or embolus
-associated with atrial fibrillation, surgery, high cholesterol, other CV disease

Question 5

what is collateral blood flow?

Answer 5

alternate or “backup” blood vessels in your body that can take over when another artery or vein becomes blocked or damaged.

Question 6

what do the consequences of ischaeic stroke depend on?

Answer 6

-collateral blood flow
-vulnerability of cells in affected area
-severity and duration of ischaemia

Question 7

describe a haemorrhage stroke

Answer 7

-a bleed
-burst blood vessel
-intracerebral haemorrhage
-loss of consciousness
-raised intracranial pressure
-associated w/ hypertension, drug use, medical conditions

Question 8

what is a subarachnoid haemorrhage? SAH

Answer 8

bleeding within the subarachnoid space

Question 9

what are examples of causes of SAH?

Answer 9

-berry aneurysm in circle of willis
-congenital abnormalities
-hypertension / vascular disease

Question 10

what is the clinical presentation of a SAH?

Answer 10

-intense headache
-vomiting
-neck stiffness
-loss of consciousness (LOC(

Question 11

what is the ischemic penumbra?

Answer 11

area of brain tissue surrounding a core of infarcted (irreversibly damaged) tissue during an ischemic stroke
- essential because they are still viable and potentially salvageable with timely medical intervention.

Question 12

what is thrombolysis?

Answer 12

medical treatment used to dissolve blood clots that have acutely blocked blood vessels,

Question 13

what is a thromectomy?

Answer 13

clot removal surgery

Question 14

list some risk factors for stroke

Answer 14

-family history
-age
-prior stroke or TIA
-high BP
-smoking
-high cholesterol
-obesity
-carotid artery disease
-diabetes
-excess alcohol intake

Question 15

what is carotid artery disease?

Answer 15

-build up of plaque in the carotid arteries - increases chances for stroke
-hthis plaque can cause blockage of the circulation to the brain or a part of the plaque can dislodge and become lodged into the brain - causing a stroke

Question 16

how do we prevent stroke?primary and secondary prevention

Answer 16

-public education - symptoms of stroke etc
-primary - diet, exercise, physical activity, weight loss, smoking cessation, avoid alcohol excess
-secondary prevention - medications

Question 17

what are examples of stroke presentation and post stroke deficits?

Answer 17

-headache
-visual disturbances
-vomiting
-cervical stiffness
LOC

deficits
-motor - loss of power, facial droop, hemiplegia
sensory - reduced sensation, inattention
speech problems
-visual deficit
cognitive impairment

Question 18

describe LOC in terms of stroke

Answer 18

-LOC might or might not be present
-average coma is 1 hour
-cause of coma is cerebral shock
-eyes deviated to side of lesion in comatose patient - ie R sided lesion, eyes to the R

nb assessment is GCS

Question 19

what is hemiparesis?

Answer 19

weakness or the inability to move on one side of the body,

Question 20

what can be seen in relation to balance following a stroke?

Answer 20

-loss of balance control
-loss of automatic postural adjustments
-may or may not have ataxia
-increased risk of falls

Question 21

what are examples of complications after stroke ?

Answer 21

-seizure
-delirium
-incontience
-pain - MSK and neurological pain
-psychological issues
-DVT
-breathing issues
-infection
-falls
-pressure ulcer
-fractures
-limb oedema
-post stroke fatigue

Question 22

what are causes of pain following stroke?

Answer 22

-spasticity
-consequence of immobility
-shoulder hand syndrome
-painful shoulder
-result of a fall
-centrasl post stroke pain syndrome

Question 23

what are examples of infections that can happen post stroke?

Answer 23

–aspiration pneumonia
-UTI

Question 24

why is the prevalence of falls so high after a stroke?

Answer 24

-due to cognitive impairment
-balance issues
-loss of co-ordination
-muscle weakness
-sensory loss
-visual disturbance

Question 25

how does weakness / hemiparesis present in a person who has had a stroke?

Answer 25

-upper limb
-lower limb
-bilateral deficits
-face / mouth / swallow
-trunk muscles
-immobility, impaired ADLs, weight transfer and functional mobility