Stroke

Alexis DeWeese
HSC 444
April 3rd, 2014

Stroke Statistics
#4 cause of death
795,000 Americans each year
1 in 5 women
1 in 6 men
Every 2 seconds someone has a stroke
Every 6 seconds someone dies of a stroke

Pathogenesis
Lack of oxygen causes brain cells to die
Affects motor and sensory function
Animation:
http://www.muschealth.com/video/default.aspx?videoI
d=
10025

Types of Stroke
Hemorrhagic: blood vessel on the brain ruptures
Ischemic: blood flow to the brain is blocked

Risk Factors
Modifiable

High blood pressure

High cholesterol

Non-modifiable

Age

Sex

Smoking

Diabetes

Weight

Family history

Relationship status

Race and ethnicity

Alcohol

Depression

Detection
Signs and symptoms
Medical history
Physical exam
Test results

F.A.S.T.
Face: Can the person
smile?
Arm: Can the person
raise both arms?
Speech: Can the person
repeat a sentence?
Time: Call 911
IMMEDIATELY

Diagnosis
Computed tomography (CT scan)
Magnetic resonance imaging (MRI)
Computed tomography arteriogram and magnetic
resonance arteriogram (CTA and MRA)
Carotid ultrasound
Carotid Angiography
Heart tests and blood tests

CT Scan

CT scan of brain after a

hemorrhagic stroke

Scan of the brain

Uses x-rays to take

pictures of the brain

Can show bleeding in the

brain or damage to brain
cells

Typically done right after

a stroke is suspected

MRI

Uses magnets and radio

waves to create pictures
of the brain

Detects changes in brain

tissue

CTA and MRA

Shows the large blood vessels in the brain
Allows the doctor to see WHERE the blood clot is
located
Gives more information about the flow of blood
through the brain

Carotid Ultrasound
Uses sound waves
to create pictures
of the inside of
carotid arteries
Allows doctor to
see whether or not
plaque has
narrowed or
blocked the arteries

Carotid Angiography

Uses a dye and x-rays

to show the inside of
the carotid arteries
Dye used makes the
artery visible on x-rays

Heart Tests

Electrocardiogram
Echocardiography

Blood Tests

Blood glucose test

Platelet count

Blood glucose test

Prevalence
795,000 Americans have a stroke each year
1/19 deaths

130,000 Americans each year

1 American every 4 minutes dies
Older
Men
African American, Alaska Native, and American Indian

Treatment
Varies on type of stroke
Ischemic stroke
Hemorrhagic stroke

Treating Ischemic Stroke

Plasminogen activator: break up blood
clots
Anticoagulants: prevent blood clots from
getting larger
Other treatment options are currently being
tested

Treating Hemorrhagic Stroke

Must quit taking anticoagulants and antiplatelet
medicines
Blood pressure medicine may be administered
Aneurysm clipping

Treating Stroke Risk Factors

Quitting smoking
Maintaining a balanced diet
Achieving and maintaining a healthy weight
Participating in physical activity regularly

Problems to watch for

Bleeding due to anticoagulants

Unexplained bruising

Bleeding from gum or nose

Bright red vomit

Blood in urine or stools

Pain in abdomen

Severe pain in head

Stroke Recovery Rates

10% recover completely
25% recover with minor disabilities
40% recover with moderate disabilities

10%

require nursing home care

15% die within a week after stroke

14% will have another stroke within a year
25% will have another stroke within 5 years

Life After a Stroke

Physical Activity
Diet
Rehabilitation

Speech

Physical

Occupational

Physical Activity
Reduces limitations and disabilities after stroke
Warm-up and cool down
Marching in place
Stationary bike
Stretching

Language, Speech, and Memory

Trouble communicating often happens after a stroke
Problems with memory and thinking clearly
Speech and language therapists

Muscle and Nerve Problems

One side or both sides of the body
Paralysis
Physical and occupational therapists

Bladder and Bowel Problems

More frequent urge to urinate
Unable to wait to use the restroom
Medicines and bowel specialists

Swallowing and Eating Problems

Trouble swallowing
Coughing and choking during eating
Coughing up food after eating
Speech therapist
Changes in the diet

Diet
Low-fat milk
Fruits and vegetables
Foods rich with Potassium
Salmon
Magnesium-rich foods
Beans

Emotional Issues and Support

Lots of changes
Recovery is a slow, frustrating process
Professional counselor
Support group
Family and friends
Positive outlook
Religion

Citations
"How is Stroke Treated?." National Heart, Lung, and Blood Institute. National Institutes of Health, 01 Febru 2011. Web.
1 Apr 2014.
<http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/treatment.html>.
"Life After Stroke." National Heart, Blood, and Lung Institute. National Institutes of Health, 01 Febru 2011. Web. 1 Apr
2014. <http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/lifeafter.html>.
Nordqvist, Joseph. "What is a stroke? What causes a stroke?." Medical News Today. (2013): n. page. Web. 1 Apr. 2014.
<http://www.medicalnewstoday.com/articles/7624.php>.
"Stroke Facts." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 17 Mar 2014.
Web. 1 Apr 2014. <http://www.cdc.gov/stroke/facts.htm>.
"Types of Stroke." National Heart, Blood, and Lung Institute. National Institutes of Health, 01 Febru 2011. Web. 1 Apr
2014. <http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/lifeafter.html>.
"What Causes a Stroke." National Heart, Blood, and Lung Institute. National Institutes of Health, 01 Febru 2011. Web.
1 Apr 2014. <http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/lifeafter.html>.
"What is stroke?." Stroke. National Stroke Association, n.d. Web. 1 Apr 2014. <http://www.stroke.org/site/PageServer?
pagename=type&printer_friendly=1>.
"Who Is at Risk for a Stroke." National Heart, Blood, and Lung Institute. National Institutes of Health, 01 Febru 2011.
Web. 1 Apr 2014. <http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/lifeafter.html>.