Stroke Prevention Flashcards
Which type of stroke has a greater cause for disability?
Haemorrhagic stroke because of the increased pressure on the brain.
What is primary prevention of stroke?
Lifestyle changes and genome sequencing for avoidance of disease before signs and symptoms occur.
What is secondary prevention of stroke?
Prevent stroke REcurrence through early detection and screening for preventing disease progression.
What is tertiary prevention of stroke?
Treatment of stroke after it has occurred to reduce the effects, severity and prevent its recurrence.
What are the barriers to stroke prevention?
Social deprivation
Education
Inadequate care continuity
What are the non-modifiable stroke risk factors?
Age
Gender: age-specific strokes are more common in men but women live longer so have more frequent
Ethnicity: Black
What are the modifiable stroke risk factors?
Hypertension
Obesity
Hyperlipidaemia
Diabetes
Atrial fibrillaiton
How does hypertension contribute to stroke?
How does diabetes increase risk of stroke?
Excess blood glucose increases the formation of fatty deposits and atherosclerosis which can rupture or form aneurysms. It leads to poorer functional outcomes following a stroke.
How does atrial fibrillation increase the risk for stroke?
Atrial fibrillation is abnormal heart rate caused by irregular and multiple firing of electrical impulses from multiple sites in the atria. This overworks the heart and doesn’t give the ventricles enough time to fill up or pump out blood enough. This allows blood to pool and form clots which can travel to the brain. Atrial fibrillation increases the risk of stroke severity by five fold and mortality.
What is the HAS-BLED score?
Used to assess the bleeding risk in patients with atrial fibrillation with increased risk for:
Uncontrolled blood pressure
Use of NSAIDS and aspirin
Alcohol
Abnormal renal and liver function: interferes with erythropoeisis
Why do NSAIDs increase risk for bleeding?
Causes vasodilation and increase activation of platelet aggregation and arterial thrombosis.
How does alcohol increase stroke risk?
Causes liver damage which interferes with the production of clotting factors. It can also lead to vasoconstriction and increase the risk of blood vessel rupture.
What medication can be used to decrease risk of stroke from atrial fibrillation?
Vitamin K antagonists such as warfarin are most effective
General anti-coagulants such as Apixaban and dabigatrian
What is a carotid endarterectomy?
Removal of fatty stenosis which significantly reduces the risk of carotid artery stroke for recent symptomatic disease, with greatest benefits for older patients. It has a lesser benefit for asymptomatic disease.
