STROKE

By Naveen, Prajwal, Mohan and Dorcas

Introduction

 Stroke is a sudden focal interruption of cerebral blood flow, causing neurological

deficit; lasting longer than 24 hours.
 No apparent cause other than vascular one.
 Can be ischemic (80%); haemorrhagic, resulting from thrombosis or embolism
(20%).
 Strokes lasting <1hour – Transient Ischemic Attack (TIA).
 Stroke damages brain tissues; TIA’s often do not. 
 In Western countries, stroke is the 3rd most common cause of death and most
common cause of neurological disability.
Detection

SIGNS AND SYMPTOMS

 Sudden numbness or weakness in face, arm, or leg (predominantly on one side of
the body)
 Sudden confusion, trouble speaking or difficulty understanding speech
 Sudden trouble seeing in one or both eyes
 Sudden trouble walking, dizziness, loss of balance or lack of coordination

01/05/2023
Detection – think F.A.S.T.

Face Arms Speech Time

Ask the person to Ask the person to Listen to the person It’s time to dial 112 if
smile. Is their face hold up both arms. speak. Is their speech you see any or all of
drooping? Does one arm drift slurred? Do the words these symptoms.. Make
or drop down? make sense? Are they a note of the time when
able to understand you the symptoms started.
and respond normally?
Prevention

Controllable risk factors include : Uncontrollable risk factors include :

 Smoking and/or drug use  Age (over 55)
 Heavy alcohol use
 Gender (males)
 Lack of exercise
 Family history (genetically predisposed)
 Unhealthy diet
 Diabetes
 Obesity
 High cholesterol
 High blood pressure
 Cardiovascular diseases including atrial
fibrillation!
Prevention

Step 2 –
Step 1 – Step 3 –
Smoke, Task
Healthy Control Step 4 Title
drugs & description
living diabetes
alcohol If you don’t smoke,
Healthy lifestyle
don’t start. If you do
changes /food
smoke, quitting will Task description Task description
choices
lower your risk

Regular physical Avoid drinking too

activity – 2.5 much alcohol, as it Task description
hrs/week can raise your BP
Treatment options

Is stroke treatable?
Patients with ischemic stroke can be
treated with tPA, a clot busting drug
which helps to unclog the blocked
blood vessel and increase the chance
of a good recovery from stroke. This
medicine must be given within 4 1/2
hours after stroke. The sooner tPA is
given, the better the chance of a good
recovery from stroke, so every second
counts! There are some
contraindications to receiving tPA, so
not everyone is a candidate.
Treatment options

• Intravenous access and cardiac

• Thrombolytic Therapy
Current treatments for acute ischemic stroke include
IV thrombolytic therapy with tissue-type
plasminogen activator (t-PA) and endovascular
therapies using stent retriever devices.
• Blood glucose control
monitoring
Patients with acute stroke require IV access and
cardiac monitoring in the emergency department
(ED). Patients with acute stroke are at risk for
cardiac arrhythmias. In addition, atrial fibrillation
may be associated with acute stroke as either the
cause (embolic disease) or as a complication.

Severe hyperglycemia appears to be independently

associated with poor outcome and reduced reperfusion in
thrombolysis, as well as extension of the infarcted territory.

Blood sugar control should be tightly maintained with

insulin therapy, with the goal of
establishing normoglycemia (90-140 mg/dL). Additionally,
close monitoring of blood sugar level should continue
throughout hospitalization to avoid hypoglycemia
Assessments for stroke

National Institutes of Health Stroke Scale aka NIHSS

1. Level of consciousness
2. Horizontal eye movements (left to right)
3. Visual field test
4. Facial palsy
5. Motor arm
6. Motor leg
7. Limb ataxia
8. Sensory
9. Language
10. Speech
11. Attention spam
Types of stroke

Ischemic Vs Haemorrhagic

Result of a blocked Result of a burst vessel

vessel
Cerebral thrombosis
This is a blood clot
caused by existing
partial blockage, such
as plaque from poor
diet
Cerebral embolism