stroke epidemiologu and presentation Flashcards
define a stroke
occurs when a blood vessel which is carrying O2 and nutrients to the brain bursts or is blocked by a clot
define TIA
-transient ischemic attack
-mini stroke
-short blockage of blood flow - temporary
- resolves within 24 hours
what are the 2 types of stroke?
-ischaemic
-haemorrhagic
describe ischemic stroke
-area of infarction
-caused by blockage - thrombus or embolus
-associated with atrial fibrillation, surgery, high cholesterol, other CV disease
what is collateral blood flow?
alternate or “backup” blood vessels in your body that can take over when another artery or vein becomes blocked or damaged.
what do the consequences of ischaeic stroke depend on?
-collateral blood flow
-vulnerability of cells in affected area
-severity and duration of ischaemia
describe a haemorrhage stroke
-a bleed
-burst blood vessel
-intracerebral haemorrhage
-loss of consciousness
-raised intracranial pressure
-associated w/ hypertension, drug use, medical conditions
what is a subarachnoid haemorrhage? SAH
bleeding within the subarachnoid space
what are examples of causes of SAH?
-berry aneurysm in circle of willis
-congenital abnormalities
-hypertension / vascular disease
what is the clinical presentation of a SAH?
-intense headache
-vomiting
-neck stiffness
-loss of consciousness (LOC(
what is the ischemic penumbra?
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.
what is thrombolysis?
medical treatment used to dissolve blood clots that have acutely blocked blood vessels,
what is a thromectomy?
clot removal surgery
list some risk factors for stroke
-family history
-age
-prior stroke or TIA
-high BP
-smoking
-high cholesterol
-obesity
-carotid artery disease
-diabetes
-excess alcohol intake
what is carotid artery disease?
-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
how do we prevent stroke?primary and secondary prevention
-public education - symptoms of stroke etc
-primary - diet, exercise, physical activity, weight loss, smoking cessation, avoid alcohol excess
-secondary prevention - medications
what are examples of stroke presentation and post stroke deficits?
-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
describe LOC in terms of stroke
-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
what is hemiparesis?
weakness or the inability to move on one side of the body,
what can be seen in relation to balance following a stroke?
-loss of balance control
-loss of automatic postural adjustments
-may or may not have ataxia
-increased risk of falls
what are examples of complications after stroke ?
-seizure
-delirium
-incontience
-pain - MSK and neurological pain
-psychological issues
-DVT
-breathing issues
-infection
-falls
-pressure ulcer
-fractures
-limb oedema
-post stroke fatigue
what are causes of pain following stroke?
-spasticity
-consequence of immobility
-shoulder hand syndrome
-painful shoulder
-result of a fall
-centrasl post stroke pain syndrome
what are examples of infections that can happen post stroke?
–aspiration pneumonia
-UTI
why is the prevalence of falls so high after a stroke?
-due to cognitive impairment
-balance issues
-loss of co-ordination
-muscle weakness
-sensory loss
-visual disturbance
how does weakness / hemiparesis present in a person who has had a stroke?
-upper limb
-lower limb
-bilateral deficits
-face / mouth / swallow
-trunk muscles
-immobility, impaired ADLs, weight transfer and functional mobility
