Week 4- TIAs and Strokes Flashcards
How many people will suffer from a stroke in their lifetime?
1/6
there is one about ever 10 minutes in australia
What is a stroke?
When blood supply to any portion of the brain is interrupted by either a blockage or rupture of arteries in the brain
What is an schematic stroke?
When blood vessels are blocked either by thrombotic or embolic events. This accounts for 80% of strokes
What is a heamorragic stroke?
Where do these occur?
Occur when there is a bleed in the brain. approximately 60% of these are due to the rupture of a small blood vessel deep in the brain and 40% are due to the rupture of larger vessel bleeding into the subarachnoid space
What is a transient ischemic attack?
Where blood supply is interrupted but quickly rested and symptoms may resolve
How long must symptoms persist for the diagnosis of a stroke to be made?
24 hours
What is the difference between a chromatic and embolic stroke?
Thrombotic- clot forms due to build up of plaque in the arteries which causes narrowing and blockage
Emolic- embolus (blood clot) reaches the arteries in the brain and occuldes them leading to a stroke
What symptoms are associated with
left hemisphere, right hemisphere, brainstem and subarachnoid strokes?
Left- defects to the right side
right- defects to the left
brainstem- virtigo, ataxia, nausea, vomminitng
Subarachnoid- worst headache ever- decreased consciousness and focal signs
What is the ischemica core?
the zone closest to the blockage/rupture that becomes necrotic with no ability to recover
What is the ischemic penumbra?
Neurons that are surrounding the core that are able to get some blood flow from peripheral/colateral artieries- can last a few hours before irreversible damage
What does the FAST pneumonic stand for?
Facial droop
Arms
Speech
Time
what is the purpose of the ambulance clinical triage for acute stroke treatment?
To improve specificity by recognising only severe clinical symptoms and optimising paramedic usability and reliability
what are the three elements of the ACT-FAST algorithm
ARM- hold at 45 degrees - if falls within 10 seconds- positive
If right arm weak- chat- positive if mute, speaking gibberish, unable to follow basic commands
If left arm- tap- positive if pt doesn’t quickly turn head and recognise you
Elegibiltiy
What is the eligibility for endovascular clot retrieval
1- defects not pre-existing
2- onset <6 hours
3- patens living at home independently
4- pts has- not comatose/bear, no history of seizure preceding symptoms, bbl above 2.8 and no definitely known active malignant brain cancer
what did the study conclude?
That the streamlined approach has advantages and can streamline transport to an endovascular centre
