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Flashcards in Stroke - Therapy Deck (26):
1

How is stroke mortality changing year on year?

It is falling

2

Why are stroke units important?

Patients do better up to 10 years after their admission

3

Why do stroke units allow patients to do better up to 10 years after their admission?

Mobilise them as soon as possible

Concentrate on simple things such as swallowing, positioning

Early therapy

Concentrating of expertise

4

What percentage of stroke patients present with swallow problems?

50%

5

How does mobilising stroke patients as soon as possible improve their prognosis?

Probability of returning home decreases by 20% for each day the patient is not mobilised

6

What does time is brain mean?

Every minute in which a large blood vessel ischaemic stroke is untreated the patient loses neurons

7

What does the patient lose per minute of untreated large vessel ischaemic stroke?

1.9 million neurons

13.8 billion synapses

12km of axonal fibres

8

What is used to restore perfusion before cell death occurs?

Thrombolysis

9

What is thrombolysis used for?

To restore perfusion before cell death occurs

10

What is thrombolysis?

The dissolution of a blood clot, especially as induced artificially by infusion of an enzyme into the blood

11

What is the dissolution of a blood clot, especially as induced artificially by infusion of an enzyme into the blood called?

Thrombolysis

12

What is usually unexpected after thrombolysis?

Haemorrhage

13

What are risk factors for haemorrhage after thrombolysis?

Infarct size

Vessel occlusion

Diabetes

Blood pressure

Age

Stroke severity

Tissue changes

Antiplatelets

14

What are some findings about using thrombolysis to treat stroke?

The benefit outweights the risk when used up to 4.5 hours after the onset of symptoms

The benefit is entirely time dependent and therefore minimising the time to the start of treatment is critical in ensuring the best outcome

15

When does the benefit of using thrombolysis to treat stroke outweight the risks?

Up to 4.5 hours after the onset of symptoms

16

What are some of the practicalities of fast treatment?

Stroke symptoms recognition

Calling for help

Altering hospital team

Alerting CT/radiology team

Keeping the patient/relatives informed

17

Who is the treatment of stroke managed by?

Stoke teams

18

What is another treatment, other than thrombolysis, for the treatment of stroke?

Endovascular clot retrieval

19

What is endovascular clot retrieval?

Procedure that removes a blood clot that is blocking the blood flow to the brain

20

What is a procedure that removes a blood clot that is blocking the blood flow to the brain?

Endovascular clot retrieval

21

What are contraindications to thrombolysis?

Age

License currently limited to <80 years old

Stroke outcomes worse anyway in over 80s

 

22

What is an example of a thrombolysis?

Alteplase

23

What is secondary prevention of strokes done by?

Antiplatelets

Statin

Blood pressure drugs

Carotid endarterectomy

24

What are examples of antiplatelets?

Aspirin

Dipyridamole

Clopidogrel

25

What is a sign that a stroke is to come?

Transient ischaemic attack

26

What percentage of people who have a transient ischaemic attack will have an acute stroke in the future?

33%

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