1. Don’t Be Numb to the Signs of a Stroke Julia Thomas, PT Director of Therapy Services

2. What is a Stroke? A stroke occurs when blood circulation or blood flow to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen.

3. Types of Stroke Ischemic ▫A blockage of a blood vessel in the brain or neck ▫87% of strokes Hemorrhagic ▫Bleeding in the brain ▫Bleeding in the spaces surrounding the brain

4. Transient Ischemic Attack (TIA) A warning sign that may last only a few moments and then disappears Although brief, they identify an underlying serious condition that isn’t going away without medication Unfortunately since they clear up, many people ignore them Recognizing and treating TIA can reduce your risk of a major stroke

5. Impact of Stroke Fifth leading cause of death ▫Every 4 minutes someone dies of a stroke ▫Stroke deaths: 40% males; 60% females Leading cause of sever disability 795,000 strokes per year in the U.S. – one every 40 seconds ▫About 85.6 million Americans are living with some form of cardiovascular disease or after effects of stroke ▫Over the past 10 years, death rate has decreased 34% and the number of deaths has decreased 18%

6. F.A.S.T. Face, Arm, Speech, Time to Call 911

7. F.A.S.T. Face dropping ▫Does one side of the face droop, or is it numb? Ask the person to smile. Arm weakness ▫Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? Speech difficulty ▫Is speech slurred? Are they unable to speak or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue”. Is the sentence repeated correctly? Time to call 911 ▫If the person shows any of the symptoms, even if the symptoms go away, call 9-1-1 to get them to the hospital immediately.

8. Other Symptoms Sudden numbness of weakness of the leg Sudden confusion or trouble understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause

9. Stroke is an EMERGENCY Call 911 Do not call your doctor Check the time so you’ll know when symptoms first appeared tPA must be administered within the first 3 hours of onset of symptoms People who receive treatment within 3 hours have lower incidence of disability Time lost is brain lost

10. Diagnosis Physical and neurological exam Imaging tests: CT and MRI Electrical tests: EEG and Evoked response test Blood flow tests: ultrasound and angiography Tests determine type of stroke, location of clots and guide treatment

11. Treatment – Acute tPA-Tissue Plasminogen Activator or “Braino” ▫The only FDA-approved clot busting drug that can be administered within 3 hours ▫Reduces disability ▫Only 3-5% of people get to the hospital in time Aspirin (at onset or 24 hours after tPA) Endovascular procedures (for removing large blood clots or placing coils) Surgery – if there is an AVM or rupture, a clip is placed at the base Supportive care

12. Treatment – Post Acute Early therapy ▫Anti-coagulants (aspirin, warfarin) ▫Surgical interventions (stents, carotid endarterectomy) ▫Blood pressure medication Preventive measures: Rehabilitation: neuroplasticity Return home with continued therapy

13. Uncontrollable Risk Factors Family history of heart disease or stroke Age ▫Risk doubles each decade after 55 Race ▫African-Americans have a higher risk Genetic blood clotting disorder Prior stroke ▫Risk is 10x higher for someone who has had a TIA Gender ▫Men have higher risk

14. Controllable Risk Factors High blood pressure ▫Leading cause of stroke Diabetes ▫Most diabetics also have high blood pressure, high cholesterol and are obese Smoking ▫Especially in conjunction with oral contraceptives or hormone replacement therapy Artery disease ▫Arteries narrowed by fatty deposits create clots Atrial fibrillation ▫A heart rhythm disorder that can cause clots

15. Controllable Risk Factors Sickle cell disease ▫The sickle cells tend to stick to arterial walls High blood cholesterol ▫Low HDL may increase risk in men Heart disease ▫Higher risk of stroke Poor diet ▫High sodium can raise blood pressure, high fat can raise cholesterol, excess calories increase obesity Physical inactivity and obesity ▫Increases risk

16. Prevention Check blood pressure regularly and take medications Take cholesterol lowering medications Do not smoke Control diabetes Exercise at least 30 minutes a day Healthy diet – low in fat and salt Regular check-ups

17. Resources www.strokeassociation.org www.heart.org www.cdc.gov/stroke/facts.htm My Life Check – a simple 7-minute assessment that checks your risk for stroke and heart disease

18. Take care of your brain. You only have one!

19. Julia Thomas, PT Director of Therapy Services Slidell Memorial Hospital (985) 280-2760 Julia.Thomas@SlidellMemorial.org

20. Our Next Lunch & Learn… June 24, 2016 “As You Wish: Advanced Care Planning Options” Dominique Perez, LMSW & Gil Ganucheau To register, please call (985) 280-2657.