Stroke Revision

Question 1

prevalence

Answer 1

152,000 annually suffer stroke.
20% die 
25% of women have stroke before 65
1 case of stroke every 5 mins
Annual cost 6 billion (nice 2008)

Question 2

Risk factors

Answer 2

high blood pressure most important contribute to 50% of all strokes .
People from african and afro caribbean communities more at risk
smoking doubles risk of stroke - causes arteries to become furry (nhs, 2011)

Question 3

Ischaemic stroke

Answer 3

85% of strokes are ischaemic.
Its a blockage of blood to the brain
could be a progressive thrombus which is growing and similar to blocked arteries
or a cerebral emboli which is a clot from somewhere else, a floating debris
blood clot or air bubble (stroke association 2014)

Question 4

haemorrhagic stroke

Answer 4

15% of strokes are hemorrhagic

Aneurysm - weakened area in congential artery
affects younger pop under 40.
Spontaneous hypertensive bleed due to bp >200/100
Malformed artery 50% younger than 30 years

Question 5

TiA

Answer 5

like stroke symptoms but improve within 2 -24 hours.
Temp disruption of blood flow to the brain.
A warning sign for stroke 15% have TIA 1st
Mimicked by low blood sugar
1 in 20 will have true stroke in 3 months (nhs, 2015)

Question 6

Modifiable risk factors

Answer 6

High blood pressure
Smoking
Alcohol
Uncontrolled diabetes
Uncontrolled heart disease

Question 7

Multiplying risk factors

Answer 7

High blood cholesterol
Sedentary lifestyle
Obesity
Seasons - Autumn and spring
Stress

Question 8

Risk factors unable to control

Answer 8

Affects more men than women
Afro caribbean twice as high risk
people who have had prior strokes
heredity
Diabetes - twice the risk than general pop
sickle cell disease (stroke association, 2014)

Question 9

Symptoms of haemorrhagic

Answer 9

sudden dramatic violent headache
visual disturbance
flashing lights, aura,
nausea, vomiting
neck and back pain
sensitivity to ight
weakness one side
can be like migraine (cross 2008)

Question 10

symptoms of ischaemic

Answer 10

harder to detect 
FAST assessment
facial drop 
numbness
tingling
language disturbance
visual disturbance (cross 2008)

Question 11

LEFT brain stroke

Answer 11

right side paralysis
speech and language disturbance
behavioural change
swallowing problems

Question 12

RIGHT brian stroke

Answer 12

spatial perception awareness
co ordination problems
perception

Question 13

Window of time

Answer 13

180 minute window - max 270 minute window

Need to treat fast - goal is to restore blood flow
the longer brain without o2 and glucose the ore brain cells die.

Question 14

FAST Assessment

Answer 14

Face Arm Speech Time stroke assessment (NHs uk 2010)

Question 15

Altiplase

Answer 15

medication - breaks up blood clot formulation

is for ischaemic stroke and can give if within 270 minutes of stroke and if scan shows no bleed on brain. (nice, 2007)

Question 16

NICE 2014

Answer 16

Nice guidance recommends everyone have a brain scan and be offered aspirin or if allergic another anti platelet drug.