EPIDEMIOLOGY AND PREVENTION OF STROKE

INTRDUCTION Stroke (cerebrovascular disease ) : Sudden loss of brain function due to vascular lesions Leading cause of death Major source of morbidity & disability & of high economic impact $ Can occur in children but different risk factors 1

DESCRIPTIVE EPIDEMIOLOGY Incidence: In usa after age of 75 = 10-20/1000 High risk groups: Age:- Stongly related to  age -After age of 55 incidence doubles in each successive decade - Mortality  with age Sex: > in males Race:- Mortality more in blacks in usa 3

DESCRIPTIVE EPIDEMIOLOGY Time trends: There is a striking  in stroke mortality attributed mainly to: HTN control Secodary prevention of stroke among TIA patients  smoking in some countries Impoved treatment measures 4

أول نصرة للرسول عليه الصلاة والسلام....أن ننتصر على أنفسنا د خالد البكر

RISK FACTORS Generally similar to CAD Major risk factors: 1- hypertension (The major risk factor) 2- Smoking 3- Hyperlipedemia 4- DM 5- Heart disease 6- Polycythemia 7- Thrombocythemia 5

RISK FACTORS Other risk factors: 6 1- Positive family history 2- Cotraceptive pills 3- Previous history of stroke or TIA 4- Presence of carotid bruit 5- Obesity 6- Physical inactivity 7- High alcohol intake 8- drug abuse 9- trauma 10- Presence of CAD or peripheral vascular disease 6

PREVENTION 1- Primary prevention By detecting(including screening) and cotrolling the risk factors especially: HTN Smoking Hypercholesterolaemia DM Heart disease TIA Polycythemia 7

PREVENTION 2- Screening and early detection Asprin use suggested but not yet proven The important role of community health action 2- Screening and early detection No definite test for early detection of stroke Screening for carotid bruit (by auscultation or non invasive testing) among persons with established stroke risk factors may be wise 8

PREVENTION 3- Treatment A: For acute stroke Rehabilitation Anticoagulants ( for some cases ) B: For preventing further stroke Antiplatelet therapy(asprin or other drugs) Carotid endarterectomy(in some cases) 9