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Flashcards

Stroke

Amelia Tuffley Paramedics Inglês 25 flashcards

Flashcards do conjunto (25)

  1. 1Blood flow to the brain750mL/min
    20% of blood volume circulates through the brain
  2. 2Brain regulating mechanisms we can influenceCarbon dioxide concentration - too low causes vasoconstriction
    Oxygen concentration - hyperoxygenation causes oxidative stress, free radicals,
  3. 3Define embolic/ischaemic strokeAn episode of neurological dysfunction caused by cerebral, spinal or retinal infarction
  4. 4Most commonly affected vessels1. Middle cerebral artery
    2. Posterior cerebral artery
    3. Basilar artery
    4. Vertebral artery
    The larger the artery affected, the greater the affected area and associated deficit
  5. 5Pathophysiology of ischaemic stroke1. Plaque ruptures, or tumour, fat globules, air or amniotic fluid
    2. Thrombus formation, typically at origin or bifurcation of arteries
    3. Plaque formation with fibrous fab -> degradation of cap by macrophages, initiation of thrombus formation
  6. 6Causes of embolism- Vascular stasis
    - Stenotic vessels
    - AF
    - AMI
    - Aneurysms
    - Thromboembolism
    - Gas embolism
    - Amniotic fluid embolism during child birth
    - Fat embolism in major fractures
  7. 7Virchow's triad- Hypercoagulability
    - Haemodynamic changes - stasis, turbulence
    - Endothelial injury/dysfunction
  8. 8Large vessel occlusion, vessels affected- <20% of AIS
    - Most severe stroke with worst prognosis
    - Middle cerebral artery
    - Internal carotid artery
    - Basilar arteries
  9. 9Arterial dissection facts- 20% of AIS <25 years
    - Females 3x more likely than males
    - Chiropractors and hairdressers dangerous
    - Neurological symptoms and a sore neck -> arterial dissection until proven otherwise
  10. 10Risk factors for embolic stroke (7)- AF
    - Endocarditis
    - Dilated cardiomyopathy
    - Recent MI
    - Heart valve replacement
    - Rheumatic heart disease
    - Patent foramen ovale
  11. 11Risk factors for thrombotic stroke (7)- Hypertension
    - Hyperlipidaemia
    - Diabetes
    - Smoking
    - Obesity
    - Systemic atherosclerosis
    - Hypercoagulable state
  12. 12Intracerebral haemorrhagic stroke pathophysiologyRapidly developing clinical signs of neurological dysfunction attributable to a focal collection of blood within the brain parenchyma or ventricular system that is not caused by trauma
  13. 13Subarachnoid haemorrhagic stroke pathophysiologyRapidly developing clinical signs of neurological dysfunction and/or headache because of bleeding into the subarachnoid space, which is not caused by trauma
  14. 14Haemorrhagic stroke presentation- Severe sudden headache in 95% of victims, often occipital lobe
    - 50% have a warning leak, mild headache
    - Upper neck pain -> inflammation of CSF
    - Photophobia
    - Nausea and vomiting
    - Hypertension
    - Bradycardia
    - Herniation - late stage
  15. 15Other "stroke"An episode of acute neurological dysfunction presumed to be caused by ischaemia or haemorrhage persisting >24 hours or until death, but without sufficient evidence to be classified as one of the above
  16. 16Transient ischaemic attack (TIA), pathophysiology and relation to stroke predictionNeurological deficit that resolves within 24 hours
    1 in 2 TIAs will progress to stroke. 1/2 within 12 months
  17. 17Stroke epidemiology- 80% of strokes can be prevented
    - one occurs every 10 mins in Aus
    - One of Australia's biggest killers and cause of disability
  18. 18Non-modifiable risk factors for stroke- Age
    - Gender
    - Family history of stroke
  19. 19Modifiable risk factors for strokeTIA
    Hypertension
    Smoking
    High cholesterol
    Poor diet and lack of exercise
    Obesity
    Diabetes
    Alcohol
    AF
  20. 20Lateral pointine syndrome- Presents scarily similar to narcotic overdose
    - Basilar artery
    - Pinpoint pupils
    - Respiratory depression
    - No response to naloxone
  21. 21Locked in syndrome- Basilar artery
  22. 22Five aspects of neurological assessmentLOC
    Motor function and tone
    Sensory function
    Speech
    Pupillary response
  23. 23Differential diagnoses of strokeIntracranial space-occupying lesion
    Subdural haematoma
    Multiple sclerosis
    Head injury
    Hypoglycaemia
    Seizure disorders – Todds paresis (one sided paralysis -> resolves)
    Complex migraine
  24. 24Endovascular clot retrievalMost benefit for large vessel occlusion
    Up to six hours post onset of symptoms
    Posterior circulation stroke up to 24 hours due to poor prognosis
  25. 25Pre-hospital stroke caresOxygen - causes oxidative stress
    Head position - semi-recumbent is haemorrhagic, supine is ischaemic
    Aspirin - can't tell if clot
    Magnesium - no benefit found

Informações

Descrição
Paramedics (CSB335) FlashCards sobre Stroke, criado por Amelia Tuffley em 11-11-2018.
Criado por
Amelia Tuffley
Visualizações
6
Tags
paramedicscsb335qut
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