2. What is the cause? Disruption of blood flow to the brain Plaque
Foreign debris, clot
Broken vessel

3. Signs and Symptoms of STROKE
Hemorrhagic
Sudden and dramatic
Violent explosive headache
Visual disturbance
Nausea and vomiting
Neck and back pain
Sensitivity to light
Weakness on one side

4. Signs and Symptoms of STROKE
Ischemic Stroke
Harder to detect
Weakness in one side
Facial drooping
Numbness and tingling
Language disturbance
Visual disturbance

5. Left Brain Damage Right side paralysis Speech and language disturbance
Behavioral changes
Swallowing problems

6. Right Brain Damage Left side paralysis Spatial perception Coordination

7. Use a “FAST” STROKE assessment
A screen system to detect Stroke patients
Face
Arm
Speech
Time of onset

8. FACE Look for Facial Droop
Have the patient smile or show his/her teeth
NORMAL: both sides of the face move equally
ABNORMAL: one side of the patient’s face droops or does not move

9. ARMS
Motor weakness: look for arm drift by asking the patient to close eyes and lift arms, palms up
NORMAL: arms remain extended equally
ABNORMAL: one arm drifts down compared to the other

10. SPEECH
The patient is asked to say “You can’t teach an old dog new tricks”
NORMAL: Phrase repeated clearly and plainly
ABNORMAL: Words slurred, abnormal or unable to speak

11. ABNORMAL SPEECH Slurring of speech Unable to think of words
Inappropriate words
Expressive aphasia: unable to speak words
Receptive aphasia: unable to understand words

12. TIME OF ONSET
The window of opportunity to effectivelly treat STROKE is 3 hours (180 min)
Maybe extended to 4 ½ hours
Difficult when
patient lives alone or
woke up with symptoms

13. Primary stroke care 180 min window of time
The longer the brain remains without oxygen and glucose the more brain cells die
Goal is to restore blood flow as soon as possible

14. Treatment after stroke
A rehabilitation unit in the hospital with
in-patient therapy
A subacute care unit
A rehabilitation hospital with individualized inpatient therapy
Home therapy
Returning home with outpatient therapy