1. EPIDEMIOLOGY AND PREVENTION OF STROKE

2. 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

3. 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

4. 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

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

6. 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

7. 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

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

10. 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

11. 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