Stroke Flashcards
(23 cards)
What is a CVA?
Acute neurological damage that lasts longer than 24 hours
Disruption of blood supply causing damage to brain tissue
What is an ischaemic stroke, and what percentage of strokes are ischaemic
It is a stroke caused by a blockage in the blood vessel
85%
What is an haemorrhagic stroke, and what percentage of strokes are haemorrhagic
Bleed in or around the brain. Or on the surface
15%
What does TIA stand for
Transient ischaemic attack
Name some demographics of stroke
152,000 per year 115-150/100,000 population 13/100,000 children 400 children strokes per year 1.2 million stroke survivors today
What is the incidence of dysphagia in stroke cases
40-78% cases
76% of those with initial dysphagia will remain moderate/severe
15% profound
What Is the incidence of aphasia in stroke patients
1/3 stroke survivors
30-43% remain affected long term
What is a cerebral thrombosis
An artery blocked in the cerebral vascular system
What is a cerebral embolism
A clot formed in Another part of the body which travels to the cerebral vascular system becoming lodged
Name 4 other possible aetiologies that could cause an ischaemic stroke
Atherosclerosis- plaque build up on inside of artery walls
Small vessel disease- they become blocked
Heart conditions- more susceptible to clots
Arterial dissection- tears develop in lining of artery
Ischaemic stroke risk factors
Smoking High blood pressure High cholesterol Obesity Alcohol Diabetes
Haemorrhagic stroke aetiologies
- hypertension -50%
- cerebral amyloid angiopathy - amyloid protein builds up in blood vessels making them more likely to tear
- aneurysm- weak spot, walls become thin
- anti coagulant meds- prevent clotting
Risk factors for a haemorrhagic stroke
- Illegal drugs such as cocaine which irritates the blood vessel walls
- Cardiovascular disease
- Stress as this raises blood pressure
How would medical professionals make a clinical diagnosis of a stroke
Rule out other conditions such as migraines, epilepsy, dementia, TIA
What are the 4 categories of the oxford stroke classification
- Total anterior circulation syndrome (TACS)
- partial anterior circulation syndrome(PACS)
- Posterior circulation syndrome (POCS)
- lacunar syndrome (LACS)
What is required to be diagnosed with Total anterior circulation syndrome (TACS)
3 of the following
- higher dysfunction (eg Aphasia or decreased consciousness)
- homogeneous hemianopia (visual field loss)
- motor and sensory defects (2/3 face arm, leg)
What is required to be diagnosed with PACS
2 of the following
- higher dysfunction (eg Aphasia or decreased consciousness)
- homogeneous hemianopia (visual field loss)
- motor and sensory defects (2/3 face arm, leg)
What is required to be diagnosed with POCS
1 of the following
- cerebellar or brainstem syndrome
- loss of consciousness
- isolated homonymous hemianopia
What’s required to be diagnosed with LACS
-subcortical stroke 1 of the following - unilateral weakness -pure sensory stroke -ataxic hemiparesis
Ischaemic treatment
Within 3 hours
Intravenous thromboblysis ( clot buster)
Intra arterial clot extraction
Aspirin daily
Haemorrhagic treatment
Blood pressure and haemorrhage monitored and controlled
Sent for brain imaging
How do you prevent re occurance
- lifestyle modification eg smoking, diet
-blood pressure reduction
(ACE inhibitors or beta blockers) - anti thrombotic treatment - eg aspirin
- lipid lowering - statins
Models for therapy care
Paternalistic- patient gives consent
Professional as agent- patient input but clinician makes final decision.
Informed decision -
Decision is entirely down to the patient when they have been fully informed
Shared decision-
Clinician and patient reach consensus
