What is a stroke?
Death of brain tissue from hypoxia
What are the 3 different types of stroke?
- Infarction of tissue
- Haemorrhage into the brain tissue
- Temporary ischaemia (TIA)
What is the acronym for recognising the signs of a stroke?
FAST
- Facial drooping
- Arm weakness
- Speech difficulty
- Time
what is a TIA?
transient ischaemic attack (temporary mini stroke)
What commonly causes a TIA?
platelet emboli from vessels in neck block bloodflow to brain and cause localised loss of brain function
What is the recovery time for TIAs? (rough estimate)
Full recovery within 24hrs
- most recover in 30 mins
What risk factors increase a patients risk of developing a stroke?
- hypertension
- smoking
- alcohol
- ischaemic heart disease
- atrial fibrillation
- diabetes mellitus
What sex is more likely to die from a stroke?
Male > female
What is the most common type of stroke?
Infarction stroke (85%)
What can cause an embolie stroke?
Embolism travels from left side of heart can be caused by:
- atrial fibrillation
- heart valve disease
- recent MI
Atheroma of cerebral vessels
What are other less common causes of stroke?
- venous thrombosis
- “border zone” infarction
- vaculitis
what is a ‘borderzone’ infarction?
- severe hypotension
- causes cardiac arrest
what is vasculitis?
narrow blood vessels to brain
How can strokes be prevented?
- smoking cessation/diabetes control/hypertension control
- antiplatelet action
- anticoagulants
- carotid endarterectomy
- preventative neurosurgery
What drugs are used for antiplatele action?
- aspirin
- clopidogrel
- dipyridamole
what drugs are used to provide anticoagulation action?
- warfarin
- apixaban
How can strokes be investigated?
- imaging
- assess risk factors
What imagine techniques are used to investigate strokes?
- CT scan
- MRI scan
- Digital Subtraction angiography
What are the pros and cons of using a CT scan to investigate stroke?
Pro = rapid, easy access
Con = poor for ischaemic stroke
What are the pros and cons of using a MRI scan to investigate stroke?
Pro = better at visualising early changes of damage
Con = difficult to obtain quickly
How can risk factors of a stroke be investigated?
- check BP
- ECG (check for arrhythmias)
- carotid ultrasound
- cardiac ultrasound
- diabetes screen
- thrombophilia screen (young patients)
What is the effect of a stroke?
- Loss of functional brain tissue (nerve cell death)
- Gradual or rapid loss of function
- Inflammation in tissue surrounding the infarct/bleed
What motor complications can a patient face after a stroke?
- dysphonia
- swallowing
- difficulty moving
What sensory complications can a patient face after a stroke?
- lack of body perception
- lack of feeling
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