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Stroke… What does this mean to you?

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1 Stroke… What does this mean to you?
Dr. Mouhammed Kabbani, M.D. Lisa Belling, NP-C Bethany Girtler, RN

2 Objectives Develop an understanding of what organ a stroke affects.
Develop an understand about what a stroke is. Develop an understanding of stroke risk factors. Understand that a stroke is preventable. Develop an understanding of how to prevent a stroke. Identify what to do if a stroke occurs. Develop an understanding of stroke treatment options.

3 How Many?

4 Mortality

5 Knowledge

6

7 So, what is a stroke? A brain injury caused when a blood vessel to the brain becomes blocked or bursts, cutting off blood flow and oxygen to the brain. When injury occurs to the brain, and part of the brain can not get the blood (and oxygen) it needs, the brain cells die.

8 Types of Strokes Ischemic (Clot or Blockage) 87%
This is the most common type of stroke Caused by a blockage in the blood vessels to the brain Hemorrhagic (Bleeding) 13% Caused by a burst or leaking blood vessel in or around the brain

9 Causes for an Ischemic Stroke
Blocked blood vessel Fatty deposit Blood clot Thrombus: A blood clot from at a fatty deposit Embolus: A traveling particle get stuck in a blood vessel

10 Transient Ischemic Attacks (TIAs)
TIAs are “warnings” that can happen before a major stroke Occurs when there is low blood supply to the brain or it is briefly blocked TIAs are temporary but have the same symptoms as a stroke TIAs are medical emergencies.

11 Causes for a Hemorrhagic Stroke
Weakened blood vessel ruptures Aneurysm: Ballooning of a weakened spot of a blood vessel Arteriovenous Malformation (AVM) Cluster of abnormal blood vessels

12 Strokes are Preventable!
80 % of strokes can be prevented with healthy behavior modifications The long term affects of strokes can be minimized with immediate treatment

13 How to Identify How do you know if someone is having a stroke?
Know the symptoms!

14 Picture From: http://www. joeniekrofoundation

15 Warning Signs Body Language

16 What To Do If You Think Someone Is Having a Stroke
Immediately call or the Emergency Medical Service (EMS) number Check the time so you’ll know when the first symptoms appeared.

17 Why Spotting a Stroke Is Important
The sooner a stroke victim gets to the hospital, the sooner they’ll get life saving treatment. A clot-busting drub called tissue plasminogen activator (tPA) may improve the changes of betting better, but only if you get help right away. Endovascular Treatments

18 Clot Busting Medication
Referred to as tPA or Alteplase. Medication works BEST when given within the first 90 minutes of stroke ONSET Medication can be given up to 4.5 hours from the stroke onset for some people The sooner the medication is given the better the outcomes Call 911 – Do Not Wait!

19 Why Time is Important Clot Buster
Every minute counts to save the brain cells and function! The rest of the brain can be protected from further loss.

20 What Else Can Be Done? New Treatments Available
Requires Specialized Equipment Requires Specially Trained Physicians Neuro-Interventional Suite

21 Catheter Based Rescue Therapy for Ischemic Strokes
Skilled physician guides catheter to the correct portion of the brain Start Here- Catheter Groin

22 Retrievable Stents for Ischemic Stroke
Solitaire stent: SWIFT Trevo Pro stent: TREVO

23 Suction Device for Ischemic Strokes
BLOOD CLOT VACUUM - SUCTION

24 Hemorrhagic Strokes Intracerebral Hemorrhage (ICH) = Bleed Inside the brain Blood Pressure Control, Reversal of Bleeding Cause Surgery Subarachnoid Hemorrhage = Bleed Around the Brain Ruptured Aneurysm Catheter Based Treatment Available

25 Worst Headache of Your Life!

26 Aneurysm Treatment - Coiling
Skilled physician guides catheter to the correct portion of the brain Start Here- Catheter Groin

27 Aneurysm Coiling

28 Stroke Risk Factors Things we can’t control Things we can control
Age Gender Race Family history Previous stroke or TIA High blood pressure Smoking & heavy alcohol use Diabetes High cholesterol/plaque buildup Atrial fibrillation (irregular heart beat) Physical inactivity Obesity

29 How Do You Reduce Your Risk?
National Stroke Association recommends that you follow these guidelines to help people reduce their risk for stroke. Many strokes are preventable if you pay attention to pre-existing medical conditions and control lifestyle factors such as diet and exercise. National Stroke Association recommends the following public stroke prevention guidelines. References: Gorelick PB. Stroke Prevention. Arch Neurol. 1995;52: At: Gorelick PB, Sacco RL, et al. Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281: At:

30 Stroke Prevention Guidelines
Know your blood pressure. Have it checked at least annually. If it is elevated, work with your healthcare professional to control it. Find out if you have atrial fibrillation (Afib) – a type of irregular heartbeat. If you have it, work with your healthcare professional to manage it. If you smoke, stop. 1. Know your blood pressure. Have it checked at least annually. If it’s elevated, work with your healthcare professional to keep it under control. Having high blood pressure, or hypertension, increases stroke risk four to six times. 2. Find out if you have atrial fibrillation – a type of irregular heartbeat. If left untreated, Afib can increase stroke risk four to six times. 3. If you smoke, stop. Smoking doubles stroke risk. References: Gorelick PB, Sacco RL, et al. Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281: At:

31 Stroke Prevention Guidelines
4. If you drink alcohol, do so in moderation. 5. Know your cholesterol number. If it is high, work with your doctor to control it. 6. If you are diabetic, follow your doctor’s recommendations carefully to control your diabetes. 4. If you drink alcohol, do so in moderation. Recent studies have suggested that modest alcohol consumption (up to two glasses of wine or the alcohol equivalent) may reduce stroke risk. If you don’t drink, don’t start. 5. Find out if you have high cholesterol. High cholesterol can indirectly increase stroke risk by putting people at greater risk of heart disease. Talk to your doctor if your total cholesterol is higher than 200 mg/dL or if you LDL cholesterol is higher than 100 mg/dL. 6. If you are diabetic, follow you doctor’s recommendation carefully to control your diabetes. People with diabetes have a significantly higher stroke risk. This may be related to circulation problems that diabetes can cause. References: Gorelick PB, Sacco RL, et al. Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281: At:

32 Stroke Prevention Guidelines
Include exercise in your daily routine Enjoy a lower sodium (salt) and lower fat diet If you have circulation problems, work with your healthcare professional to improve your circulation. If you experience any stroke symptoms, call immediately. Every minute matters! 7. Incorporate physical activity that you enjoy into your daily routine. Active people tend to have lower cholesterol levels. Regular exercise also seems to slow down or stop clogging of blood vessels. 8. Enjoy a low-sodium (salt) and low-fat diet. Too much salt may contribute to high blood pressure and make it more difficult to control. A diet that is low in fat will likely include vegetables, lean meats such as chicken and fish, low-fat dairy products and a limited number of eggs. 9. Ask your healthcare professional if you have circulation problems which increase your risk for stroke. If you do, work with your healthcare professional to control this condition. 10. If you experience any stroke symptoms, seek immediate medical attention by calling Every minute matters! References: Gorelick PB, Sacco RL, et al. Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA. 1999;281: At:

33 The Perception of Stroke
Myth Stroke is not preventable Stroke cannot be treated Stroke only strikes the elderly Stroke happens in the heart Reality Up to 80% percent of strokes are preventable Stroke requires emergency treatment Anyone can have a stroke Stroke is a “Brain Attack” There are a lot of misperceptions of stroke…. Myths: Stroke is not preventable Stroke cannot be treated Stroke only strikes the elderly Stroke happens in the heart Stroke recovery ends after 6 months However, the Realities of stroke are: Up to 80% of strokes are preventable. We’ll discuss steps you can take to reduce stroke risk in a minute. Stroke requires emergency treatment. Call 911 immediately if you experience or see someone with stroke symptoms. Anyone of any age can have a stroke. Stroke is a “Brain Attack.” Stroke recovery can continue throughout life.

34 B.E. F.A.S.T. Time is Brain

35 Questions?


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