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Define Stroke List types of Strokes List risk factors for Stroke Identify the signs and symptoms of Stroke Stroke is the No. 3 cause of death in the U.S. after HF and Cancer On average, every 53 seconds, someone in the US experiences a stroke. Every 3.1 minutes someone dies of a stroke Stroke risk increases with age. For each decade after age 55, the risk of stroke doubles. 71% of all strokes occur in people over the age of 65 A rapidly developed clinical signs of focal (or global) disturbances of cerebral functions, lasting >24h or leading to death & due to a vascular disorder. Causes: Blockage (blood clot) occurring inside a blood vessel Blood vessel leaks blood due to rupture Ischemic Stroke (85%) Hemorrhagic Stroke (15%) Types of Ischemic Stroke Embolic Stroke Blood clot travels to the brain Thrombotic Stroke Blood flow is blocked to the brain Bleeding occurs from vessels within the brain. High blood pressure or a rupture of a blood vessel or an aneurysm may be the cause. Duration < 24h. But more commonly lasting 20 min. frequency Single or multiple Time course May recur over weeks or months Patterns 50 % thrombotic, 10 – 30 % embloic, 10 – 15 % lacunar. Significance Risk of stroke after TIA is 10 – 60 % in the first 5 years. Stroke does not Discriminate Stroke affects people of All Ages All Ethnic Groups All Backgrounds Most strokes are preventable, take steps NOW to reduce having a stroke! Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause Strokes occur in the brain and affect the opposite side of the body Blood Pressure over 120/80? Smoker – exposed to tobacco? Overweight? Diabetes? High Cholesterol? Heart Disease? Family History of Stroke? Man over age of 45, OR a woman over 55 years of age? Risk factors you can control: DIET - How we eat, do we follow our diet? EXERCISE - Do we exercise or get some physical activity? MEDICATIONS - Taking medications correctly SMOKING - Stop smoking Strokes can affect different parts of the brain, this results in patients experiencing different symptoms If you are having a Stroke come to the hospital right away – 997 Diagnostic Testing CT or MRI of the brain EKG Carotid Ultrasound Echocardiogram ECG – may show atrial fibrillation Carotid Ultrasound – will show if there is stenosis (narrowing of the blood vessel) Echocardiogram – detects if any thrombus (blood clot) within the heart chambers Any labs may be ordered start with Glucose level why ? , Lipid Profile (checking your cholesterol level) is done on all patients. 3 Simple Questions Ask the person to smile Ask the person to raise both arms Ask the person to say a simple sentence “The sky is blue in Boston” Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people's lives and enhance their chances for successful recovery Ischemic strokes, the most common type of strokes, can be treated with a drug called t-PA, that dissolves blood clots obstructing blood flow to the brain. Time is very important in order to receive this medication Window of opportunity to start treating stroke patients is 3 to 4 and a half , but to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes. Aspirin Plavix Blood pressure medication if appropriate Cholesterol lowering medicines if needed Medical Management Dietary Physical & Occupational Therapy Speech Therapy if indicated Nursing Rehabilitation Physical Medicine Consult Determine what type of therapy best for patient Rehab Unit Subacute Rehab Extended Care Facility Home Care with PT/OT Starts upon admission to the hospital Consult social worker or care coordinator to help identify discharge needs Provide patient/family with Stroke education THANK YOU….
