Stroke AwarenessJason C. Zydallis

Raritan Valley Community CollegeNursing

What is a Stroke?o Interruption of blood flow to the brain

resulting in tissue ischemia or deathoCommonly known as a “Brain Attack”oStrokes are Medical Emergencies!oBrain cells begin to die from lack of

oxygeno The extent of disability is dependent on the

area of the brain involved.o Early Treatment is key to decreased disability

Stroke StatisticsoEach year 700,000 Americans suffer a

strokeoStroke is the 3rd leading cause of death

among cancer and heart diseaseoStroke accounts for more serious long term

disabilities than any other diseaseoHighest risk after age 65, however, the risk

of stroke doubles each decade after 55oStroke is more common in men especially

African Americans.

Types of Strokeso Ischemic stroke – restriction of blood supply to

the brain resulting in inadequate oxygeno Two types : Thrombotic and Embolico Thrombotic strokes result from developing a clot

usually due to vessel narrowing over timeo Embolic strokes results when a piece of an existing

clot breaks off and occludes a vesselo Ischemic strokes are the most common types of

strokeso Hemorrhagic strokes are the second type of stroke

and are caused by ruptures vessels inside the brain

Normal vs. Occluded ArteryIschemic Stroke

Many factors lead to the occlusion of arteries such as high blood pressure, diabetes, smoking, and high cholesterol diets

Cerebral Hemorrhage (Bleeding)

High blood pressure is #1 cause!!

Transient Ischemic Attack (TIA’s)oMore commonly known as “Mini

Strokes”oAre considered a warning sign of

progressive cerebro-vascular disease (vessels of the brain)

oMany only last up to an hour but can last for 24 hours

TIA Signs and Symptomso Signs: Sudden severe headache with no known causeo Temporary loss of vision in one eye or double visiono Numbness or loss of sensation to one or both sides of the

bodyo Inability to speako Dizzinesso Facial droopingo Difficulty walkingo Difficulty swallowingo These are not normal occurrences. Seek Emergency Care!o If untreated symptoms may resolve, but can progress to a

full blown stroke!

Nonmodifiable Risk FactorsThese are the factors that we have no control

over but may increase the risk of strokeAge – Over 65 stroke increases Gender – Men have increased risk but women

have an increased mortality rate

Race – African Americans have increased riskFamily History – Prior history of TIA’s or past

strokes increases the risk for having another attack

Important: Present any symptoms to your physician!

Modifiable Risk Factorso These factors are controllable and prevent the risk of

strokeo High Blood Pressure – alone is the highest risk for stroke

and is the least recognized (50% increase in risk)o Heart Disease – Atrial Fibrillation the most common

arrhythmia and most treatable (20% increase in risk)o Diabetes - Increases the risk by 5 times the normal

population for uncontrolled blood glucoseo Smoking – Doubles the risk of having a strokeo Cholesterol – High fat diets increase narrowing of the

arterieso Obesity – Increases blood pressure, fat molecules in the

arteries, and high blood glucoseo Sedentary Lifestyle – Lack of exercise

What do we do to decrease our risk?oAddressing our modifiable factors…

o Consume a healthy diet with less fats and increased fruits and vegetables also decrease salt intake

o Weight Control helps decrease risk for increased blood pressure

o Blood Pressure Control – Check your blood pressure often and adhere to medicine regimen

o Regular exercise – 30mins of walking 3 times per week has shown great benefit to cardiovascular health

o Stop Smoking – Smoking both damages and constricts vessels in your body

o Regular visits to your primary care provider to maintain best quality of health

What can medicine do for you?o Many advances in healthcare have been made which greatly increase

our life expectancyo Here are some procedures that can decrease the risk of suffering a

strokeo Carotid Endarterectomy – Surgical procedure to manually remove the build up

of plaque inside of the carotid arteryo Carotid Angioplasty – Same day procedure, vessels accessed through your

groin and the artery is opened and stented to ensure positive blood flowo MERCI – mechanical removal of the clot o Anti-platelet drugs – Help decrease the occurrence of clots in high risk

patients Ex: Aspirin, Plavixo Statins – Decreases the cholesterol levels in the blood which may decrease the

buildup of additional plaques in the vessel Ex: Lipitor, Zocor, and Mevacoro TPA – Given for ischemic strokes only can be administered to help decrease

effects of a stroke. Only given to those who meet strict criteria and requires inpatient monitoring in a medical facility

o As you can see there are many options for care as well as following the guide to prevention of strokes

Lipids and Cholesterol Important to monitor cholesterol

levels as well as the amount of fats in your diet

LDL’s “Bad Cholesterol” should be lower than 100 mg/dl

HDL’s “Good Cholesterol” should

be greater than 40 mg/dl

**If your doctor tells you that you have High Cholesterol ask for the results**

Sample Lipid/Cholesterol Panel

Insulin Insulin control is very important

to prevent damage to blood vessels

Glucose monitoring should be implemented if you have diabetes and strict adherence is necessary

General information about Glucose Levels and what they

mean…

Normal Target Fasting Blood Glucose for Non-Diabetics = 70-

100 mg/dl and less than 130 mg/dl after meals

Normal Target Fasting Blood Glucose level for Diabetics =

70-130 mg/dl and less than 180 mg/dl after meals

Blood PressureBlood Pressure should be monitored regularly to ensure

normal levelsLevels should be checked by your MD every visitMonitors can be purchased for home usage

Blood Pressure Interpretations

120/80 mmHg – Optimal140/85 mmHg – Pre-Hypertension

150/90 mmHg – Stage 1 Hypertension170/100 mmHg – Stage 2 Hypertension

*Follow up with your PCP if you have episodes of “High” Blood Pressure*

Body Mass Index (BMI) A comparison of height and weight on a standardized scale

Good = 19.5 – 25Mild Obesity = 25-30

Obese = >30

Anabolic Steroids and StimulantsIncrease Blood Pressure further increasing

risk for stroke Increase the amount of cholesterol in the

blood Increased fluid retention in the body

increases blood pressureStimulants increase pulse and metabolic rate

causing adverse cardiac functionBefore starting any weight loss pills you

should consult with your doctor because it may interfere with current health problems

Alcohol Use More than 2 drinks a day increase risk by

50%Most strokes occur within the first hour after

alcohol consumptionAffects the liver “thins the blood” causing

increased hemorrhagic strokes.Increases the bad cholesterol in your blood

resulting in plaque accumulation in the vessels

THE END

Any questions or comments?