1 / 17

TOBACCO AND STROKE

TOBACCO AND STROKE. Mini-Lecture 1: Module: Tobacco and the Nervous System. Objectives of the Mini Lecture. Goal of Mini Lecture: Provide students with knowledge about how tobacco causes stroke and the effect of tobacco on different types of stroke. Learning Objectives:

aguy
Download Presentation

TOBACCO AND STROKE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TOBACCO AND STROKE Mini-Lecture 1: Module: Tobacco and the Nervous System

  2. Objectives of the Mini Lecture Goal of Mini Lecture: Provide students with knowledge about how tobacco causes stroke and the effect of tobacco on different types of stroke. Learning Objectives: Students will be able to: • Describe how tobacco causes stroke • Understand the effect of tobacco on different types of stroke • Explain the effect of smoking cessation on stroke

  3. Contents Core Slides: • Smoking and Stroke: Causation • Smoking and Cerebral Blood Flow • Smoking and Ischemic Stroke • Smoking and SAH • Smoking Cessation and Stroke • Stroke Patients Continue to Smoke Optional Slides: • Smoking and Hemorrhagic Stroke • Nicotine and Cerebral Vasculature (1–3)

  4. CORE SLIDES Tobacco and Stroke Mini Lecture 1 Module: Tobacco and The Nervous System

  5. Smoking and Stroke: Causation1 • Increases peripheral thrombus formation • Changes in cerebral blood flow (CBF) • Breakdown of the blood-brain barrier • Alterations in cerebro-vascular endothelium http://repairstemcell.files.wordpress.com/2009/04/stroke.jpg 1. Hawkins et al. 2002

  6. Smoking and CerebralBlood Flow1 • Acute smoking: increases CBF • Chronic smoking: decreases CBF • Differential regional sensitivity to nicotine exposure: • CBF increased in thalamus, pons, visual cortex, cerebellum, right para-hippocampus • CBF decreased in left para-hippocampus http://www.strokegenomics.org/img/stroke_isc_web.jpg 1. Hawkins et al. 2002

  7. Smoking and Ischemic Stroke • Smoking along with diabetes mellitus, ischemic heart disease, and valvular heart disease: Causal risk factors for ischemic stroke.1 • Smoking > 15 cigarettes/day: Risk factor for cerebral infarction among young adults and adults (15-49 years).2 http://i.ehow.com/images/GlobalPhoto/Articles/4602008/83425-main_Full.jpg 1. Hankey 2006; 2. Naess et al. 2004

  8. Smoking and SubarachnoidHaemorrhage (SAH) • Smoking: independent risk factor of subarachnoid haemorrhage (SAH)1 • Promotes formation, growth and rupture of intracranial aneurysm1 • Risk of SAH: Current smoker: 5 times > than non-smoker 2 http://1.bp.blogspot.com/_JgDQHWpAXtk/SHWOq2P25ZI/AAAAAAAAAGE/GWFx3YQ_Gsw/s320/sah_coronal_berry_2_275.jpg • 1. Feigin et al. 2005; 2. Anderson et al. 2004

  9. Smoking Cessation and Stroke • Smoking cessation increases cerebral perfusion.1 • Recommended to prevent myocardial infarction and recurrent stroke.2 • 1. Hawkins et al. 2002; 2. Bak et al. 2002

  10. Stroke PatientsContinue to Smoke • Only 22% of stroke patients quit within 6 months after first stroke.1 • Only 20% of moderate and heavy smokers reduced smoking by 50%.1 • 37% of SAH stroke patients resumed smoking 3 months after initial stroke.2 • 1. Bak et al. Stroke 2002;33:2263-9 2. Ballard et al. Stroke 2003;34:1859-63

  11. Importance of Smoking Cessation • Assess smoking status of stroke patient. • Explain negative effect of smoking on stroke risk and strongly advise to stop. • Continually assess and remind patients not to restart smoking.

  12. OPTIONAL SLIDES Tobacco and Stroke Mini Lecture 1 Module: Tobacco and The Nervous System

  13. Smoking andHemorrhagic Stroke Risk: Current vs. Never smokers • Intra-cranial hemorrhage (ICH): • Men: 2.06 times • Women: 2.67 times • Subarachnoid hemorrhage (SAH): • Men: 3.22 times • Women: 4.02 times http://i.ehow.com/images/GlobalPhoto/Articles/4602008/83425-main_Full.jpg 1. Kurth et al. 2003a; 2. Kurth et al. 2003b

  14. Nicotine and CerebralVasculature (1) • Stimulates DNA synthesis  endothelial cell proliferation increased  lesions in arterial lumen  increased stroke incidence • Induces endothelin release from human endothelial cells http://www.sbirc.ed.ac.uk/cyril/gfx/cp_neurophysio_vascular_cerebral_arteries.jpg 1. Hawkins et al. 2002

  15. Nicotine and CerebralVasculature (2) • Changes gene expression in primary human coronary artery endothelial cells  stimulates angiogenesis  increased stroke incidence • Impairs endothelium dependent vasodilatation • Disrupts tight junctions of blood brain barriers(BBB) → increased BBB permeability http://ucneurologysurvivalguide.pbworks.com/f/1238165575/1238165575/cerebral%20territory%201.JPG 1. Hawkins et al. 2002

  16. Nicotine and CerebralVasculature (3) 1. Hawkins et al. 2002

  17. The most important health message a doctor can give to patients is to quit smoking.

More Related