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Project 4: Stroke Logan Stephenson

Project 4: Stroke Logan Stephenson. What is stroke?.

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Project 4: Stroke Logan Stephenson

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  1. Project 4: Stroke Logan Stephenson

  2. What is stroke? Blood vessels called arteries supply the brain with oxygen rich blood. A stroke occurs when one of these arteries gets blocked or bursts and this flow is cut off resulting in a lack of blood flow and oxygen to the brain. The longer the blood supply is cut off, the worse the damage becomes and eventually that area of the brain will die. Picture found at: http://www.christoph14.de/aktuell/bilder/021507a2.jpg

  3. Stroke caused by blood clots: Ischemic A blood clot blocks an artery and cuts of the blood flow to the brain Stroke types • Stroke caused by bleeding: • hemorrhagic When a blood vessel breaks blood rushes into the brain and damages it. An example would be an aneurysm Picture found: http://celebritydiagnosis.com/wp-content/uploads/2010/01/strokes.jpg

  4. Effects of stroke on the left side of the brain • Weakness, numbness or paralysis on the right side of your body • Trouble speaking, understanding speech, or following directions. • Trouble reading, thinking, learning or remembering • Difficulty swallowing

  5. Effects of stroke on the right side of the brain • Weakness, numbness, paralysis on the left side of the body. • Visual problems, problems with short term memory • Ignoring or neglecting objects or people on the left side of your body. You can even ignore your own arm and leg on the left side of your body.

  6. Risk factors that can't be controlled • Age: Stroke can happen at any age, however the older people get the more at risk they become. Most strokes happen to people over 65. • Gender: The risk of stroke is greater for men until women reach menopause, then the risk evens out. • Family history: If any of your family members have had a stroke under the age of 65 then your risk is heightened. • Ethnicity: Indians, Africans, Asians have a greater amount of high blood pressure and diabetes problems which makes them more at risk. • Your own history of stroke: If you have had a stroke in the past, your chances are very high of having another.

  7. Risk factors that can be controlled • High blood pressure • High blood cholesterol • Heart disease/atrial fibrillation (irregular heart rate) • Diabetes • Being overweight • Excessive alcohol • Inactivity • Smoking • Stress

  8. Warning signs of a stroke • Weakness: sudden weakness or loss of power in the face, arm or leg. Can be accompanied by numbness. • Troublespeaking: loss of speech, garbled speech, or difficulty understanding speech. • Vision: sudden loss of vision in one eye, or double vision. • Headache: sudden severe and unusual headache • Dizziness: Sudden loss of balance especially if you have any of the other signs.

  9. If you have any warning signs if stroke, or see any warning signs in others it is important to dial 911 immediately. The faster you get to the hospital the better your chances. Picture found:http://1.bp.blogspot.com/_gcA0ZuKGkI8/S7ZPuHqQNOI/AAAAAAAAGyw/eR_wuFYQlHk/s1600/ambulance.gif

  10. What happens when you get to the hospital? • You will be taken to a bed immediately where a team of nurses and doctors will be waiting for you. • They will take your blood pressure, pulse and temperature, as well as attach you to a heart monitor • Your past medical history will be obtained, if you are not able to speak the history will be obtained from your family • The team starts the IV and takes your blood work • You will quickly be taken for a CAT scan to determine if you have had a stroke and what type • Treatment will be decided based on this information

  11. Additional testing may include MRI (magnetic resonance imaging) a large magnetic field is used to make 3 dimensional pictures of the brain. This test has limitations because some people may be claustrophobic or have metal implants in their body which prohibit them from going in the scanner Picture taken at Foothills hospital MRI department by Logan Stephenson

  12. Treatment Depending on what type of stroke you have, how bad the stroke is, and how quickly you get to the hospital there are 3 main forms of treatment, all designed to restore blood flow to the dying brain. • TPA (the clot bust drug) • Surgery • Mechanical removal of the clot

  13. TPA TPA is referred to as the “clot bust drug” because it works by breaking apart the clot. It can only be given to a stroke caused by clots in the blood vessel because the risks of bleeding are great. If it were to be given to someone that had a stroke caused by bleeding it may be detrimental. It must be given withing four and a half hours of the onset of symptoms. “For years, there was very little we could do for stroke patients. The research that showed we could use clot busters to stop and reverse stroke has revolutionized its treatment and made a critical difference to tens of thousands of people around the world” Michel Hill MD Picture found:http://www.strokeunitglos.nhs.uk/userfiles/docstore/images/tpa.jpg

  14. Surgery Sometimes a patient may need surgery to remove the blood that has gathered in the brain after a hemorrhagic stroke. In some cases a life saving procedure called a hemicraniectomy may be performed. This involves removing a portion of the skull to allow the brain to swell out. The piece of skull that has been removed will eventually be replaced (usually around 6 weeks after). If the brain were allowed to swell inside the skull, it would put pressure on the brain stem and eventually the patient would stop breathing. Surgery may also be required to repair a broken blood vessel in the brain or to clear plaque from the carotid artery.

  15. Mechanical removal If tPA is not indicated for the patient , they may be taken to the Cathlab to have the clot removed by a mechanical device. A catheter is a thin flexible tube that is introduced through the groin into the femoral artery and threaded up to the brain. The clot is then broken apart by the catheter, sucked out or pulled out depending on which type of catheter is used. This catheter is called the Merci device. Picture found: http://msnbcmedia.msn.com/j/msnbc/Components/Newsweek/Photos/mag/040308_Issue/040228_stroke_hu.hmedium.jpg

  16. Additional treatments Other treatments are all targeted to minimize the damage caused by stroke. -Aspirin or other blood thinners such as Plavix -High blood pressure medication -Medication to lower cholesterol -Therapies such as physical therapy, occupational therapy, and speech therapy are very important in regaining function

  17. Prevention -Get your blood pressure checked -Exercise regularly -Try to maintain a healthy weight -Have your cholesterol levels checked -Avoid fatty foods, follow a healthy low fat diet -Quit smoking -Avoid excessive use of alcohol

  18. Effects of stroke

  19. Stats on death and disability Deaths • Six percent of the total deaths in Canada are due to stroke, it is third leading cause of death in Canada • Nearly 14,000 Canadians die as a result of stroke each year • Although more men than woman have strokes more woman then men die from stroke each year Prevalence -There are over 50,000 strokes in Canada each year (one stroke every 10 minutes). -About 300,000 Canadians are living with the effects of stroke. -After the age of 55, the risk of stroke doubles every 10 years. -A stroke survivor has a 20% chance of having another stroke within 2 years. Stats taking directly from: Heart and Stroke Foundation of Canada

  20. Stroke costs Stoke costs the Canadian economy $3.6 billion a year. For one patient the total cost of care in the first 6 months is about $50,000. Costs are greater as the levels of disability increase. A patient out of pocket typically spends at least $2,000 within the first 6 months. This is very difficult when it is the primary bread winner in the family that has been affected by stroke. Picture found:http://www.letscollaborate.us/graphics/PatientInHospBed.jpg

  21. Prognosis The prognosis is difficult to predict as it depends on the type of stroke, the amount of brain damaged, which areas of the body have been affected, and how quickly the treatment was received. Half of the people that have had a stroke are able to function independently at home even though some may have permanent loss of function. People who have a stroke due to blood clot, typically have a better chance of survival then those who have a stroke caused by bleeding in the brain.

  22. Genetics Genetics may play a part in stroke. We know that if there is a family history of stroke particularly with ones father, your risk of stroke is strong. Inherited genetic disorders that cause connective tissue problems are associated with stroke from hemorrhage, for example Marfan's syndrome or moyamoya disease. There are also inherited deficiencies in factors called protein C and S that inhibit blood clotting and may eventually lead to stroke. Genetic factors account for between 7-20 percent of subarachnoid hemorrhage (a type of bleeding stroke) In fact people who have two or more first degree relatives who have had this type of stroke are screened by MRI for aneurysms.

  23. References • Most all information was found in: Heart and Stroke: Lets Talk About Stroke information manual. • http://www.righthealth.com/topic/HowToPreventStroke/overview/adam20?fdid • http://adam.about.com/reports/0000452.htm • http://www.heartandstroke.com/site/c.iklQLcMWJtE/b.348399/k.34A8/statistics.htm • http://www.cbc.ca/health/story/2010/06/07stroke-cost.html • YOU'VE HAD A TIA- Heart and Stroke foundation booklet • Special thanks to the members of the Calgary Stroke Program

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