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NDDs/Stroke > Treatments & Prevention > Flashcards

Treatments & Prevention Flashcards

1
Q

An Ischaemic stroke is fundamentally different from a Haemorrhagic stroke. How?

A

Ischaemia is loss of blood flow

Haemorrhages are uncontrollable bleeds into the brain

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2
Q

Ischaemic Stroke

What is immediately affected?

A

Ischaemic core

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3
Q

Ischaemic Stroke

Loss of oxygen and glucose to the Ischaemia core will cause…

A

Cause necrosis (cell death) within minutes

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4
Q

Ischaemic Stroke

The ______ can grow and grow as time goes by

A

Structural lesion

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5
Q

Ischaemic Stroke

The structural lesion can grow as time goes by, increasing

A

The severity of functional impairment

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6
Q

Which scan is most commonly used in stroke assessment?

A

CT scan

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7
Q

Why are CT scans more commonly used than fMRI?

A

Readily available
Do not take as long
Cheaper

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8
Q

CT scans cannot pick up a stroke…

A

In it’s early hours

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9
Q

CT scans can rule out…

A

Haemorrhagic stroke

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10
Q

A doctor asking about name, DOB etc can…

A

Assess speech, comprehension and disorientation simultaneously

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11
Q

Hankey & Warlow, 1999

What is a general treatment option, for all kinds of stroke?

A

A specialised stroke unit

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12
Q

Ischaemic Stroke

Treatments are targeted towards the…

A

Ischaemic Penumbra

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13
Q

What is the penumbra?

A

Area surrounding the event (throbosis/embolism)

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14
Q

If the penumbra is not treated, cells die within…and…

A

Hours

The core will continue to expand

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15
Q

4 treatments for an Ischaemic stroke?

A

Thrombolitic (TPA)
Aspirin
MERCI Retriever
Suction Removal

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16
Q

3 limitations of Thrombolitics?

A
  1. Limited TTW
  2. Risk of haemorrhage
  3. Must consider other health issues
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17
Q

Hankey & Warlow (1998)

Identified the limitation of thrombolitics as being…

A
  • Only appropriate for 10% of population, as must be given within a few hours
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18
Q

What are the two surgical options for an Ischaemic stroke?

A

MERCI retriever

Suction removal

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19
Q

What is a MERCI retriever?

A

Device to pull the blood clot from an artery using a coiled wire

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20
Q

What is suction removal?

A
  1. Clot attacked with wire

2. Clot remains sucked out with tube

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21
Q

Why are surgical options not considered often?

A

They carry many risks

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22
Q

Haemorrhagic strokes are difficult to treat - the main goal is

A

Managing symptoms/reducing pressure and swelling in brain

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23
Q

What is the pharmaceutical option for Haemorrhagic strokes?

A

Hypertensives

24
Q

What are the two surgical options for Haemorrhagic strokes?

A
  1. Aneurysm Clipping

2. Coil Embolisation

25
Q

What is Aneurysm Clipping?

A

This is where a clip is used to prevent blood flow from oozing out

26
Q

What is coil embolisation?

A

Insertion of wire which coils at the bleed

27
Q

Aneurysm Clipping and Coil Embolisation are…

A

Surgical options for Haemorrhagic strokes

28
Q

Describe how brain injury following a stroke can progress?

A

Ischaemic core can continue to expand if left untreated

29
Q

Is the focus more on treating strokes, or preventing strokes?

A

Preventing

30
Q

4 NON-modifiable risk factors for stroke?

A

Age
Gender
Ethnicity
Family History

31
Q

Which gender is more at risk of stroke?

A

Males –> progesterone in females may be protective

32
Q

Alpert (2011)

People over the age of ____ are at greater risk of stroke.

A

55

33
Q

Why are the elderly population more at risk of stroke?

A

Changes in blood vessels (thinning + stiffening)

34
Q

Why might somebodys ethnicity put them more at risk of stroke?

A

Increased risk of HT/Diabetes

35
Q

If somebody has Hypertension, blood moves through arteries ….

A

Quicker

36
Q

Hypertension

The quick moving blood…

The body compensates by…

A

Knocks against artery walls

By increasing blood vessell thickness

37
Q

Hypertension

If blood vessells are thickened, the area narrows and…

A

Chance of clotting is increased

38
Q

Hypertension can be reduced by…

A

Employing a low salt diet

39
Q

5 MODIFIABLE risk factors?

A
  1. Hypertension
  2. Cardiac diseases
  3. Diabetes
  4. High cholesterol
  5. Lifestyle
40
Q

Alpert (2011)

___ of patients who suffer a TIA will have a stroke within _____

A

10-15%

3 months

41
Q

Both _____ and _____ attack BV walls

A

Glucose

Tobacco toxins

42
Q

How can chlesterol increase the risk of a stroke? (2)

A
  1. Break off and block off small BV’s

2. Sit in areas of damaged blood vessel

43
Q

Alpert (2011)

Smoking, even secondhand smoke damages…. and accelerates…

A

Blood vessels

Hardening of the arteries

44
Q

Hankey and Warlow (1999)

A treatment with a more substantial effect (thrombolysis) can have no more overall effect that weaker treatments, unless…

A

It can be given to more than a small minority of patients

45
Q

What is the No1 modifiable cause of stroke?

A

Hypertension

46
Q

Alpert (2011)

To avoid the risk of stroke, the following steps should be taken (4)

A
  • Not smoking
  • Reg. exercise
  • Normal bodyweight
  • Low fat diet, F + Vs
47
Q

Following Alpert’s (2011) recommended lifestyle choices, the risk of….

A

Firs time stroke can be decreased by up to 80%

48
Q

What effect does Glucose have on blood vessels?

A

Can damage BV walls, and can build up and block BVs

49
Q

Hankey & Warlow (1999) found that statins…

A

Could reduce risk by 24%

50
Q

Hankey & Warlow (1999) identified 3 ways in which stroke risk could be reduced initially?

A
  • Controlling Hypertension
  • Cholesterol reduction
  • Stopping cigarette smoking
51
Q

Hankey & Warlow (1999)

____ of stroke patients have had a previous stroke

A

1/3

52
Q

Hankey & Warlow (1999)

Thrombolysis is only apprioriate for ____

A

10% of the stroke population

53
Q

Hankey & Warlow (1999)

Pre-requisites to Thrombolysis (4)

A
  1. Given within few hours
  2. Be properly assessed
  3. No contradiction to thromblysis
  4. CT to rule out haemorrhage
54
Q

Hankey & Warlow (1999)

___ of previous stroke sufferers have ______

A

50%

Hypertension

55
Q

Hankey & Warlow (1999)

Which is the only treatment accessible to all patients?

A

Organised stroke care

NDDs/Stroke (9 decks)

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