Stroke prevention Flashcards
Primary prevention =
avoidance of disease before signs and symptoms develop
Secondary prevention =
avoidance of progression or later problems
Non-modifiable RF for stroke =
Age
Gender
Race
Family Hx
Modifiable RF for stroke =
Hypertension Diabetes Atrial fibrilation Smoking Hyperlipodaemia Obesity
Most likely to cause ischemic stroke in young people:
dissection cardioembolism from PFO endocarditis Vasculitis genetic illicit drug use
Most likely to cause intercranial haemorrhage in young people:
AVM
Hypertension
Aneurysm
Clotting disorders
Why does hypertension increase risk of stroke?
- accelerate atherosclerosis
- increase shear on vessel walls
- increase risk of wall rupture
- small vessel disease
Why does smoking increase risk of stroke?
- accelerates atherosclerosis
- increases platelet adhesion
- carotid stenosis
Primary prevention strategies:
Exercise
Diet
Medications
Score used to risk assess for stroke:
CHADS2-VASc
CHADS2-VASc stands for:
C - congestive heart failure H - hypertension - A - Age >75 - D - Diabetes - S2 - prior TIA or stroke V- Vascular disease (MI etc.) A - age 65-74 Sc - Female
Ways to treat AF:
Cardioversion
Anti-coagulation
Rate control
The prevention paradox in relation to stroke:
majority of people who suffer from stroke aren’t at high risk. Population measures have large benefit on comminty but little benefit on individual.
What should be done after an ischemic stroke?
- Treat blood pressure, even if ‘normal’
- Treat AF with DOAC
- Anti-platelet therapy
- Consider statin
DOAC =
Direct oral anti-coagulant
