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Cardiovascular System > Stroke Therapy > Flashcards

Stroke Therapy Flashcards

1
Q

Why are stroke units important? (4)

A
  • Mobilisation is rapid and increases the probability of returning home
  • Swallowing and positioning
  • Early therapy
  • Concentrating of expertise
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2
Q

Every minute that there is a large vessel ischaemic stroke left untreated a patient loses(3)

A
  • 1.9 million neurons
  • 13.8 million synapses
  • 12km of axonal fibres
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3
Q

What is the aim of thrombolysis

A

To restore perfusion before cell death

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4
Q

Penumbra

A

An area surrounding an ischaemic event

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5
Q

Evidence for thrombolysis (4)

A

 21 trials with 7152 patients
 1995 NINDS 0-3-hour benefit
 2008 ECASS III 3-4.5 benefit
 2011 IST3 benefit in over 80s

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6
Q

Thrombolytic drug

A

Alteplase

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7
Q

What is there a risk of when using thrombolytic drugs like alteplase

A

Haemorrhaging

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8
Q

Treatments of stroke

A

Thrombolysis

Clot retrieval

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9
Q

What are the risk factors for Haemorrhaging after thrombolysis

A
  • Infarct size
  • Vessel occlusion
  • Diabetes
  • Blood pressure
  • Age
  • Stroke severity
  • Tissue changes
  • Anti-platelets
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10
Q

Clot retrieval trials (6)

A 
	MR CLEAN
	ESCAPE
	EXTEND-IA
	REVASCAT
	SWIFT-PRIME
	THRACE
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11
Q

What is a Hemicraniectomy

A

used to relieve the increased intracranial pressure and brain tissue shifts that occur in the setting of large cerebral hemisphere mass or space-occupying lesions.

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12
Q

When is a Hemicraniectomy considered (4)

A
  • Individuals aged up to 60 years
  • Suffer from acute MCA territory ischaemic stroke
  • Complications: cerebral oedema
  • Offered within 48 hours of stroke onset
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13
Q

Secondary prevention (4)

A
  • Clopidogrel (75mg)
  • Aspirin (75mg plus dipyridamole MR 200mg bd)
  • Statin
  • Blood pressure drugs
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14
Q

What is Clopidogrel and what does it do? (2)

A

Antiplatelet

Prevents blood clots

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15
Q

What is aspirin and what does it do (2)

A

Blood thinning medicine

Reduce blood clot

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16
Q

What is Dipyridamole

A

Anticoagulant that stops platelets clumping together

used in combination with “blood thinners” such as warfarin to keep clots from forming

17
Q

What is Statin and what is it used for

A

Group of medicines that helps lower blood cholesterol (LDL)

18
Q

Carotid Endarterectomy

A

Procedures used to remove build up of fatty plaques

19
Q

Carotid Endarterectomy in 50-69% stenosis

A

Reduces risk of death by 7-9%

20
Q

Carotid Endarterectomy in >70% stenosis

A

Reduces risk of death by 14-19%

21
Q

When is surgery necessary for carotid stenosis?

A
  • Anterior circulation
  • 70% occlusion
  • Uncertainty if asymptomatic
  • TIA or stroke with good recovery

Cardiovascular System (42 decks)

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