[go: up one dir, main page]
Scribd
Upload
6 views4 pages

Strokes

Stroke is defined as an acute, focal neurological deficit caused by ischaemia, with two main types: ischaemic (80%) and haemorrhagic (20%). Warning signs include motor loss, sensory loss, speech issues, vision problems, loss of balance, and intense headache, with immediate management involving thrombolytics and aspirin. Transient Ischaemic Attack (TIA) mimics stroke symptoms but resolves within 24 hours, indicating a higher risk for future strokes, and secondary prevention strategies include antiplatelet therapy, blood pressure management, cholesterol control, and diabetes care.

Uploaded by

ilkelambrechts101
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
6 views4 pages

Strokes

Stroke is defined as an acute, focal neurological deficit caused by ischaemia, with two main types: ischaemic (80%) and haemorrhagic (20%). Warning signs include motor loss, sensory loss, speech issues, vision problems, loss of balance, and intense headache, with immediate management involving thrombolytics and aspirin. Transient Ischaemic Attack (TIA) mimics stroke symptoms but resolves within 24 hours, indicating a higher risk for future strokes, and secondary prevention strategies include antiplatelet therapy, blood pressure management, cholesterol control, and diabetes care.

Uploaded by

ilkelambrechts101
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

STROKE

Acute, focal, neurological deficit caused by ischaemia

 Focal  Not global


o E.g. you won’t have global deficits

Types of stroke
 Ischaemic (80%)
o  Blood
 Thrombus
 Embolus
 Haemorrhagic (20%)
o  Blood (outside)
 Aneurysm (5%)
 Intracranial haemorrhage (HT!!!) – (15%)
Pathology
 Atherosclerosis (main with ischaemic attack)
o Risk factors
 Modifiable
 HT
 Diabetes
 Hypercholesterolemia
 Lack of exercise
 Increased weight
 Smoking
 Unmodifiable
 Age
 Gender

Haemorrhage
 Features
o Raised ICP
 Papilledema
 Progressive decreased LOC
 Intense headache
 Vomiting
o Cushing reflex   BP
NB  Haemorrhagic vs. Ischaemia  NEED CT to determine if haemorrhage (not for Dx)

Warning signs of stroke

1. Motor loss
a. Acute unilateral
i. Face, arm & leg
2. Sensory loss
a. Unilateral
3. Speech
a. Something acutely wrong with speech
4. Vision
a. Unilateral anopia or hemianopia
5. Loss of balance (acute)
6. Acute intense headache

Examination (FAST)
 Face (smile)
 Arm  Keep up for 10 seconds
 Speech  Repetition
 Time
Immediate management
 Thrombolytic (TPA)
o Window period of 4 ½ hours to give thrombolytic
 After this time the vascular beds will be too damaged and there will
be a risk of inducing bleeding to the brain when clot is lysed
 Aspirin (at any time)

Treatment
NB  When did it start!
1. TPA 0.9mg/kg  Most effective
a. Criteria for thrombolytic (NB)
i. Stroke
ii. 4 ½ hours
iii. CT to exclude haemorrhage
iv. 18‐80 years
v. NIH stroke score >4 and < 23
2. Aspirin
a. Can be given even if there is haemorrhage
3. Stroke unit

Transient Ischaemic Attack (TIA)


 Looks like a stroke but clears up within 24 hours
 70‐80% of cases only last 10 seconds
 Clot breaks up and does not obstruct vessel
o NB  Same underlying pathology as stroke (same origin)
o  risk of developing stroke in the future
 Treatment
 Aspirin 300mg
 Simvastatin 40mg
 ACE inhibitor

Secondary prevention of stroke  ABCD!


A. Antiplatelet (All TIA/Strokes) & Anticoagulant (cardiac reasons)
B. BP medication
C. Cholesterol (Statin) & Carotid end arterectomy (if stenosis > 70%)
D. Diabetes

You might also like