Stroke treatment

Question 1

stroke treatment targets (3)

Answer 1

protect the damaged brain before ischaemia becomes cell death, get rid of clot, prevent clot from happening in first place

Question 2

stroke units

Answer 2

therapists get involved very early trying to mobilise the patient and get them up and going, given nasal gastric tube so not swallowing, get images taken early and quickly, given aspirin for ischeamic stroke

Question 3

acute stroke therapies should

Answer 3

restore blood supply, prevent extension of ischaemic damage, protect vulnerable brain tissue, avoid repurfusion injury, be non toxic

Question 4

acute stroke treatment

Answer 4

alteplase ( thrombolysis) tries to kill any clot in brain and restore blood flow, can be given within four and a Half hours of stroke onset, give 10% as a bolus then rest as infusion over an hour, need to work out weight of patient, 10 out of 100 make a good recovery, 3% are made worse because it is a fibrinolytic therapy. if you can create within 90 mins of stroke then for every 100 patients, 27 will benefit, one would be harmed. if longer then the harm increases and benefit reduces

Question 5

CT or MRI

Answer 5

MRI is much more detailed but it takes an hour to get an image so CT is the fresh choice. perfusion CT if available shows if any tissue is viable. CT angiogram helps to show occluded vessel

Question 6

CT side effects

Answer 6

can cause radiation damage to hair lines

Question 7

clot retrieval

Answer 7

catheter up through the groin and pull the clot out

Question 8

other treatments

Answer 8

antiplatelets, statins, blood pressure management, anticoagulation for patients with atrial fibrillation (apixaban, rivaroxaban, edoxoban, warfarin)

Question 9

treatments for primary intracerebral haemorrhage

Answer 9

very little, get blood pressure down but unsure how