BRAIN ATTACK - STROKE

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By: Karen Peper RN MSN CFNP

Providence Hospital 9/07

Objectives
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Define Stroke
List types of Strokes

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List risk factors for Stroke

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Identify the signs and symptoms of

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Stroke

Stroke Statistics
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Stroke is the No. 3 cause of death in the

U.S. (#1 Heart Disease, #2 Cancer)

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Stroke kills more than 160,000

American each year

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On average, every 53 seconds, someone

in the US experiences a stroke.

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Stroke Statistics
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Every 3.1 minutes someone dies of a

stroke

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Stroke risk increases with age. For each

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decade after age 55, the risk of stroke doubles.

72% of all strokes occur in people over

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the age of 65

What is a Stroke?
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Brain tissue is damaged from a sudden

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loss of blood flow, resulting in a loss of neurological function Causes:

Blockage (blood clot) occurring inside a blood vessel Blood vessel leaks blood due to rupture

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Types of Strokes
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Ischemic Stroke (85%)

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Hemorrhagic Stroke (15%)

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Ischemic Stroke
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Types of Ischemic Stroke

Embolic Stroke
Blood clot travels to the brain

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Thrombotic Stroke
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Blood flow is blocked to the brain

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Hemorrhagic Stroke
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Bleeding occurs from vessels

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within the brain. High blood pressure or a rupture of a blood vessel or an aneurysm may be the cause.

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Transient Ischemic Attacks (TIAs)

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A stroke-like event lasting minutes, or hours, that occurs when the brain is deprived of oxygen-rich blood temporarily, but in which the effects wear off completely after the bloodflow returns
TIAs do not result in permanent brain damage TIA is serious and too often ignored

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PLEASE Pay Attention to these symptoms

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TIAs should not be ignored

More that 1/3 of people will go on to have an actual stroke 5% of strokes will occur within 1 month of the TIA or first stroke 12% will occur within 1 year 20% will occur within 2 years 25% will occur within 3 years

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Stroke does not Discriminate

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Stroke affects people of

All Ages All Ethnic Groups

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All Backgrounds

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Most strokes are preventable, take steps NOW to reduce having a stroke!

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Signs & Symptoms of Stroke

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Sudden numbness or weakness of the face, arm,

or leg, especially on one side of the body

Sudden confusion, trouble speaking or understanding

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Sudden trouble seeing in one or both eyes

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Sudden trouble walking, dizziness, loss of balance or coordination

Sudden, severe headache with no known cause

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Strokes occur in the brain and affect the opposite side of the body

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Everyone
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Please stand up
If you answer yes to any of the following questions, please sit down Thank you

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Risk Factors for Stroke

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Blood Pressure over 120/80?

Smoker exposed to tobacco? Overweight?

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Diabetes?
High Cholesterol? Heart Disease?

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Risk Factors for Stroke

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Family History of Stroke?

Physical activityless than a total of 30

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minutes on most days? Man over age of 45, OR a woman over 55 years of age?

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Are you sitting down?

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Yes, you are at risk for a stroke, but it

doesnt mean you will have one

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There are risk factors that can be

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controlled and risk factors that cannot be controlled

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Risk Factors
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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

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Strokes can affect different parts of the brain, this results in patients experiencing different symptoms

Strokes are an EMERGENCY

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If you are having a Stroke come to the

hospital right away CALL 9-1-1

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Once You are at the Hospital

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Diagnostic Testing
CT or MRI of the brain

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EKG

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Carotid Ultrasound
Echocardiogram

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EKG may show atrial fibrillation

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Carotid Ultrasound will show if there is stenosis (narrowing of the blood vessel)
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Echocardiogram detects if any thrombus (blood clot) within the heart chambers
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Chest X-ray
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Blood work - Labs

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Any labs may be ordered, Lipid

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Profile (checking your cholesterol level) is done on all patients.

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Recognize the Symptoms of a Stroke

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3 Simple Questions
Ask the person to smile

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Ask the person to raise both arms Ask the person to say a simple sentence The sky is blue in Boston
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ACT IN TIME
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Stroke is a medical emergency. Every

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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

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tPA (Tissue Plasminogen Activator)

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is a clot-busting drug
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Ischemic strokes, the most common type of strokes, can be treated with a drug called tPA, that dissolves blood clots obstructing blood flow to the brain.

TIME IS BRAIN
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Time is very important in order to receive

this medication

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Window of opportunity to start treating

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stroke patients is three hours, but to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes.

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Medications
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Aspirin Aggrenox
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Plavix
Blood pressure medication

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if appropriate Cholesterol lowering medicines if needed

Hospital Treatment for Stroke

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Medical Management
Dietary Physical & Occupational Therapy Speech Therapy if indicated Nursing

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Hospital Treatment for Stroke

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Rehabilitation
Physical Medicine Consult Determine what type of therapy best for patient

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Rehab Unit Subacute Rehab Extended Care Facility Home Care with PT/OT

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Discharge Planning
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Starts upon admission to the hospital

Consult social worker or care coordinator to help identify discharge needs

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Provide patient/family with Stroke education Stroke Support Group meetings

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Can you SPOT a Stroke?

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This is the end of the program

Do you have any questions??

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THANK YOU.
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