Stroke Risk Factors and Management Flashcards
What are the risk factors for stroke
Age
Hypertension
Cardiac Disease (esp atrial fibrillation)
Diabetes
Smoking
Family history
Cholesterol
Bleeding disorders
What is the most important modifiable risk factor for stroke
Hypertenstion
What are the effects of
Diabetes
Smoking
Lipids
Alcohol
Obesity
- increases the incidence of strokes up to 3-fold in both sexes.
- two-fold increased risk of ischaemic stroke.
- High plasma of LDL causes excessive amounts of LDL in artery wall
- Heavy drinking increases risk 2.5 fold
- Independant risk facto for vascular disease including stroke
What are the aims of stroke treatment
Protect the damaged brain before ischaemia becomes cell death
Get rid of the clot
Prevent the clot happening in the first place
What are the role of acute stroke therapies
Restore blood supply.
Prevent extension of ischaemic damage.
Protect vulnerable brain tissue.
Avoid reperfusion injury
Be non-toxic
When should thrombolysis be used (altepase)
Within 4.5 hours of symptom onset
or Thrombectomy
What is the treatment for TIA
Assess risk of subsequent stroke
Start aspirin
What are the investigations for stroke
Immediate CT
Then MRI
Then advanced imaging if necessary to see extent of infarction or brain loss
What are some other treatments for ischaemic heart disease
Antiplatelets
statins
Blood pressure management tablet
Anti-coagulation
What is the management of stroke
Admit patients to a specialist stroke centre
Exclude hypoglycaemia
Immediate CT
Aspirin 300 mg
What is the treatment for secondary prevention of stroke
Clopidogrel 75mg once daily
Atorvastatin 80mg should be started but not immediately
Carotid endarterectomy or stenting in patients with carotid artery disease
Treat modifiable risk factors such as hypertension and diabetes
What is a tool used to treat stroke in the community
F- face
A- arm
S- speech
T- time
