Cerebrovascular Disease Flashcards
(28 cards)
What is a stroke?
- Damage to and death of brain tissue
- Caused by disruption of blood supply to brain. No oxygen or nutrients
Risk Factors for stroke
- High cholesterol
- High blood pressure
- Obesity
- Diabetes
- Alcohol and Smoking
- Atrial fibrillation
Signs of a stroke
FAST
Facial weakness, numbness, severe headache, sight troubles
Arm/leg weakness especially on one side of the body, trouble walking and dizziness
Speech trouble, confusion understanding
Time, get them to A&E quick
What can be used to confirm if someone has had a stroke?
Brain scans - CT (Computed Tomography) - MRI (Magnetic Resonance Imaging) Run blood tests - Blood glucose test - Platelet count
Advantages/Disadvantages of CT scan
- Usually used first cos of speed (5-10 minutes)
- Can detect acute bleeding and fractures & bone breaks
- Hard to image brainstem
Advantages/Disadvantages of MRI scan
- Completed if more detail is needed for prognosis (45 mins)
- Detailed pictures of organs, soft tissue, bone another internal body structures
- Can detect small or subtle lesions
What does a blood glucose test reveal?
Blood sugar levels, if they are low they cause symptoms similar to a stroke
What does a platelet count reveal?
- They are cell fragments that help blood clot
- Not enough clotting (bleeding disorder)
- Too much clotting (thrombotic disorder)
What is used to look at the Heart?
And ECG (Electrocardiogram) and an Echo
What is a Carotid Ultrasound used for?
- Shows whether plague has narrowed or blocked carotid arteries (main supply of O2 rich blood to brain)
What could happen if plaque left within the carotid arteries is left untreated?
- Blood clot forms (thrombosis)
- A piece breaks off and goes to the brain (embolism)
What can be used to confirm/rule out diagnosis of subarachnoid haemorrhage
- Lumbar Puncture (seeing if there are any traces of blood in CSF)
- Needle in lower spine
Describe a Haemorrhagic Stroke
- Blood vessel springs a leak
- 2 main types:
Intracerebral and Subarachnoid
Discuss Intracerebral Haemorrhage (ICH)
- Rupturing of artery inside brain
- Most commonly in basal ganglia (or cerebral lobes, cerebellum and pons)
- Blood escapes into brain tissue
- It collects into a haematoma which puts pressure/ has toxic effect on surrounding tissue
- Damaged brain cells
Discuss Subarachnoid Haemorrhage (SAH)
- Rupturing of aneurysm in artery near surface of brain
- Blood into subarachnoid space
- Acute rise in intracranial pressure
- Cerebral blood flow decreases (ischaemia)
- Damaged brain cells
Describe an Ischaemic Stroke
- Blockage of blood flow (cerebral infarction)
- Accounts for majority of strokes
- 4 main types:
Embolic infarct
Thrombotic infarct
Lacunar infarct
Infarct of unknown cause
Discuss Embolic Infarct
- Blood clot (embolism) travels up from another part of body and lodges itself in a blood vessel in the brain
Discuss Thrombotic Infarct
- Blood clots forms in artery that supplies brain, causing tissue death
- Typically caused by build up of cholesterol in carotid arteries or basilar arteries
Discuss Lacunar Infarct
- High blood pressure (hypertension) leads to arterial blockage
Discuss Infarct of unknown cause
- 30% of ischaemic strokes
- sometimes from trauma, infection and tumours
How would you treat a Haemorrhagic Stroke?
- Manage blood clotting levels
- Intracranial pressure control
- Craniotomy
- Aneurysm repair (coiling or clipping)
How would you treat an Ischaemic Stroke? (Thrombolysis)
- Meds to break down clot (tPA)
- Risk of harmful bleeding in brain (7% of cases)
How would you treat an Ischaemic Stroke? (using other treatments)
- Antiplatelet meds to stop blood clotting
- Anticoagulant meds (blood thinner)
How to manage an Acute Stroke
Restoration of homeostasis
- O2 therapy
- Blood sugar control
- Blood pressure control
- Temperature
- Water balance
- Ion balance
