Stroke continued... Flashcards
(12 cards)
Risk factors for stroke
age HTN diabetes hypercholesterolemia cigarette smoking A fib asymptomatic carotid artery stenosis migraine patent foramen ovale prior stroke or TIA**
What is the “favorite” artery for emboli?
middle cerebral artery
Primary stroke prevention strategies?
treat hypertension, diabetes, hypercholesterolemia, A fib, stop cigarette smoking
Secondary stroke prevention strategies?
carotid endarterectomy vs angioplasty
antiplatelet therapy, statin
chronic anticoagulation
T/F: When you stop smoking, your risk for stroke drops almost instantly.
True
**decreases hypocoagulability of blood (blood less sticky)
Review the CHADS2 score
CHF HTN Age >75 Diabetes Previous stroke/TIA (2pts)
What’s the story with asymptomatic carotid artery stenosis?
So, they are sending teams out in vans to screen for carotid bruits (which are usu ~50-60% indicative of carotid stenosis) - this has led to increased endarterectomies
What should you do with patients with a patent foramen ovale at risk for stroke?
Leave it alone
**there is no evidence that closure of the PFO or treatment w anticoagulants will improve stroke risk
What can be done for patients with acute ischemic stroke?
IV tPA (w/i 4 hours) judicious BP management (keep BP high) IV hydration (keep volume high) intra-arterial thrombolysis (lower dose mechanically remove the clot "heroic" measures like hemispherectomy
What can be done for patients with intracerebral hemorrhage?
BP control (can lead to large hematoma if not controlled) "heroic" measures (cerebellar hemorrhage)
What is intracerebral hemorrhage?
when the blood vessel has “exploded” into the parenchyma of the brain
T/F: Both the incidence and the causes of stroke may vary widely from geographic region to geographic region.
If so, then the type of stroke management program one develops should be designed to “fit” the needs of the particular population served.
True
