Otherwise known as: - a Cerebrovascular Accident (CVA) - cerebral infarction - cerebral hemorrhagic - ischem

1. STROKE • Otherwise known as: - a Cerebrovascular Accident (CVA) - cerebral infarction - cerebral hemorrhagic - ischemic stroke

2. Definition • A stroke is a severe reduction of blood flow to the brain, resulting in a variety of permanent impairments – depending on what side of the brain is affected [1] • A stroke is an interruption of the blood supply to any part of the brain [5] • Sometimes called a “brain attack” because it is similar, in a sense, to a heart attack [5]

3. Causes • Every 45 seconds someone in the USA has a stroke • Occurs when a blood vessel in the brain is blocked, or bursts [2] • Gender and age are associated with the incidence of strokes [1] • Family history of stroke • Having things such as: - high blood pressure (#1 reason) - diabetes - high lipid levels - coronary artery disease - obesity - high cholesterol - heart diseaseall increase chance of having a stroke [4] • Current weight, distribution of body fat, eating habits and level of fitness [4] • Cocaine use, alcohol abuse, head injury and bleeding disorders increase risk of bleeding into brain [5]

4. Effects • Blood vessels • Brain • Circulatory system • Heart • Nervous system • The part of the body controlled by the damaged area of the brain can’t work properly [2] • Brain damage can begin within minutes

5. http://www.nlm.nih.gov/medlineplus/ency/imagepages/18011.htm http://www.nlm.nih.gov/medlineplus/ency/imagepages/18010.htm • Each side of the brain controls the opposite side of the body • May result in may result in functional loss or motor skill impairment

6. Stroke Effects on Eating and Nutrition • May limit ability to perform daily activities associated with eating – such as grocery shopping, preparing meals, and feeding oneself [4] • Can impair ability to swallow – may be result from weakening of the tongue or loss of coordination of tongue movements [4] • May choke of cough during and after meals [4] • Lack of gag reflex [4] • May suffer from chronic upper respiratory infection [4] • If calorie and nutrition needs cannot be met – may become malnourished, weight loss, poor appetite [4]

7. Ischemic Stroke • Happens when blood vessel supplying blood to an area of the brain is blocked by a blood clot • About 80% of all strokes are Ischemic [2] • Transient Ischemic Attack (TIA) is also known as a mini stroke – when one of more symptoms last for LESS than 24 hours [5] • Temporary loss of brain function – warning for possible future stroke [5] • It lasts for less than 24 hours but longer than a few minutes or hours [1] • Fatty deposits collect on artery walls, forming sticky substance called plaque, which temporarily blocks blood flow to particular part of the brain [5][1] • Two types of blood clots:[5] - cerebral thrombus is a clot that stays in the brain - cerebral embolism is a clot that breaks loose and moves through the bloodstream

8. Heart attack or stroke may occur when an area of plaque ruptures and a clot forms over the location [5] • Blocks flow of blood to organ's tissues [5] • Blood clot may block the passage of blood through a brain artery [5] • Deprives nearby tissue of oxygen and nutrients [5] http://www.nlm.nih.gov/medlineplus/ency/imagepages/19314.htm http://www.nlm.nih.gov/medlineplus/ency/presentations/100218_4.htm

9. Hemorrhagic Stroke • Happens when an artery in the brain leaks, bursts or ruptures [2] • Without the flow of blood, after the blood vessel has ruptured, causes damage to brain cells • Without blood and oxygen, that part of the brain will die [2] • Second major cause of stroke is bleeding in the brain [5]

10. Children and Stroke • Children can have a stroke too • Takes 2-3 times longer to get to the hospital compared to adults [3] • Causes are dramatically different from adults • Causes of childhood stroke: [3] - birth defects - infections (meningitis, encephalitis, etc.) - trauma - blood disorders (such as sickle cell disease) • Some stroke related disabilities that are unique to children [3] - cerebral palsy (babies who have stroke in womb or within first 2 years of life are at high risk) - mental disabilities - epilepsy • Other stroke complications [3] - fever - change of mental state - poor nutrition and conditions due to long period of time spent in bed

11. Symptoms • Depends on what side of brain is damaged[5] - sometimes people don’t know they had a stroke • Sudden weakness, numbness or paralysis of face, arm or leg, especially one side of the body [2] • Dizziness or unsteadiness, trouble walking • Trouble seeing in one or both eyes [2] • Slurred, garbled or inability to speak [2] • Swallowing difficulties, drooling [5] • Loss of memory [5] • Loss of balance or coordination [5] • Personality changes [5] • Severe headache • Mood changes (depression, apathy) • Drowsiness or loss of consciousness • Uncontrollable eye movements or eyelid drooping

12. Think F.A.S.T. • It is important to know the symptoms and act quickly [2]

13. Diagnosis • Very important to see a Doctor right away • If seen within 3 hours, the Doctor may be able to use medicines to lead to a better recovery [2] • Doc needs to find out what kind of stroke it was – Ischemic or Hemorrhagic – to treat with correct medicine [2] • CT scan to see if it is a clot of bleeding • May do a Carotid Arteriogram

14. Carotid Arteriogram • determine if there is narrowing or other abnormality in the carotid artery • showing a severe narrowing (stenosis) of the internal carotid artery http://www.nlm.nih.gov/medlineplus/ency/imagepages/1152.htm

15. Treatment • Ischemic Stroke – if less than 3 hours have passed since symptoms have began, doctors will use medicines that will dissolve the blood clots [2] • Hemorrhagic Stroke – can be very hard to treat. Doctors may do surgery or other treatments to stop bleeding or reduce pressure [2] • Best way to recover from a stroke is to go to stroke rehab [2] • Will help regain skills that were lost and to make the most of the ones one still has [2] • Speech therapy, occupational therapy, and physical therapy [5] • Recovery time differs from person to person

16. Prevention • Don’t smoke – it doubles your chances of having a stroke • Eat heart-healthy foods (low in fat, saturated fat and cholesterol) • Exercise on most days of the week • Control cholesterol and blood pressure • Limit alcohol consumption • Avoid getting sick from the flu • Maintain a healthy weight • Work close with doctors, go to all appointments and take all medicines • Eat a variety of foods

17. Future Outlook • There isn’t that much more for doctors to research • Mechanical technology to improve movement of the hand, wrist and elbow • There is a drug called NeuroAID to take after one has had a stroke - helps regain movement of weak muscles (no need for a wheelchair) - controls muscle spasms - clarity in speech - average appetite • As people age, if they follow the guidelines on how to prevent having a stroke, they will be at a lower risk of having a stroke

18. References • [1] Irons-Georges, Tracy. (2002). Strokes. In Magill’s Medical Guide (vol.3, pp.2181-2186). Pasadena: Salem Press, Inc. • [2] (May 14, 2007). Stroke. Retrieved April 10th, 2008 from <http://www.bchealthguide.org/kbase/topic/major/hw224638/descrip.html> • [3] (2008). Kids and Stroke. Retrieved April 7th, 2008 from <http://www.stroke.org/site/PageSaver?pagename=HOME> • [4] (2008). The Role of Nutrition in the Prevention and Treatment of Stroke. Retrieved April 10th, 2008 from <http://www.cleavelandclinic.org/health/health-info/docs/0600/0632.asp?index=4657> • [5] Weinrauch, Larry A. (March 18 2008). Stroke. Medical Encyclopedia, 33. Retrieved on April 6th, 2008 from <http://nlm.nih.gov/medlineplus/ency/article/000726.htm#visualContent> • [6] (2008). NeuroAID. Retrieved on May 16th, 2008 from <http://www.neuroaid.com/testim.php#tschneider>