Stroke therapy Flashcards
What is the best management, and improves survival after a stoke
Stroke unit care
What is the purpose of thromblysis treatment
Restore perfusion before cell death occurs
Why is thrombolysis a time dependant treatment
As the benefit of treatment delays with time, as every minute the damage worsens, making it harder for blood flow to be restored
What should be administrated on the sing of an acute stroke
Thrombolysis - but not in hemorrhagic
Why should streptokinase not be administrated in the presentation of an acute stroke
streptokinase produced from bugs casuesi increased risk of anaplhyaltic reaction to it
What is an example of a fibrinolytic agent in thrombolysis
ateplase
How is fribriolytic agent administrated in an acute stroke
Intravenously
What is the surgical from of thrombolysis performed in an acute stroke
Clot retrieval
How does clot retrieval work in the treatment of an acute stroke
mechanical removal of a blood clot from a patient’s brain
What is the disadvantage of thrombolysis in acute stroke treatment
Causes unexpected bleeding
What increases the risk factor of haemorrhage after thrombolysis
Infarct size vessel occlusion diabetes blood pressure age stroke severity tissue changes antiplatelets
Is thrombolysis going to be effective if brain tissue is dead?
No as won’t be able to perfuse the blood
What affect does age have on thrombolysis
the greater the age the greater the risk of bleeding
When would thromolysis benefits outweigh the risks
If administrated up to 4.5hours from the onset of symptoms
What protocol would be followed for patients with suspected stroke
ambulance priority (blue light) in appropriate cases
rapid triage on arrival at hospital
immediate access to specialist stroke services rapid brain imaging
rapid specialist assessment
Recognisable symptoms of a stroke
e.g. Facial weakness Limb weakness Speech disturbance (dysphasia or dysarthria) Hemianopia
What is a hemicraniectomy
— the removal of half the skull
What is the purpose of a hemicraniectomy
— has been shown to help relieve pressure and prevent herniation as the brain expands
Would should a hemicraniectomy be performed on
individuals aged up to 60 years who suffer an acute MCA territory ischaemic stroke complicated by massive cerebral oedema, surgical decompression
What is the 4 different management of ischameic stroke
Stroke unit
thrombolysis
aspirin
hemicraniectomy
When would secondary prevention management be given
Patents who have surrfered a stroke or present with TIA
What is secondary prevention treatment
Clopidogreal
aspirin
BP drugs
Statin
What is a Carotid endarterectomy
surgical procedure used correcting stenosis (narrowing) in the common carotid artery
What is the purpose of aCarotid endarterectomy
Reduces the risk of stroke
When would thrombolysis not be administered in the presentation of an acute stroke
If the stroke is due to a haemorrhage
