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stroke N beyond on world stroke day
1) Stroke is a growing global epidemic that threatens lives and quality of life, but much can be done to prevent and treat stroke through increased awareness, prevention efforts, and rehabilitation. 2) Every 6 seconds someone dies from a stroke, but stroke is both preventable and treatable through steps like controlling risk factors such as high blood pressure, diabetes, and smoking, as well as recognizing the signs of stroke and seeking immediate medical help. 3) While the lifetime risk of stroke is 1 in 6 for men and 1 in 5 for women, awareness of risk factors, symptoms, treatment options and rehabilitation can reduce deaths and
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stroke N beyond on world stroke day
- 5. ‘I was havinga great day at work and nothing seemed unusual. Suddenly the lights went out. Seven hours later I woke up in hospital. I couldn’t move my right side, and my speech had gone.’
- 6. Common believe It is heart disease It is not curable It is not preventable Etiology (reason ) not known
- 7. Reality of stroke It is brain attack Prevention is better than cure There is some curative treatment Outcome good Pathogenesis is known (reason)
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- 10. 1 in People world wide will have a stroke 6 in their life time It could be you.
- 11. 1 in People world wide will have a stroke 6 But stroke can be prevented
- 12. 1 in People world wide will have a stroke 6 Ensure quality care and support after stroke
- 13. 1 Every 2 seconds, someone in the world suffers a stroke Every 6 seconds, in someone dies Every 6 seconds, someone’s quality of life will forever be 6 changed – they will permanently be physically disabled
- 14. 1 in Every 6 seconds, regardless of age or gender – 6 Someone somewhere will die from stroke
- 15. Every 6 seconds, strokekills some one Every other second stroke attacks a person 15 millions people experience a stroke each year 6 million of them do not survive
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- 17. About 30 millionpeople have had a stroke most have residual disabilities Behind these numbers are real life
- 18. Second cause ofdeath above 60 5th – people 15- 59 Also attack children More death each year than AIDS TB malaria put together Is indiscriminate & does not respect borders
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- 26. Sudden confusion, troublespeaking or understanding Sudden trouble seeing Sudden trouble walking, dizziness, loss of balance or coordination l fb l di ti Sudden, severe headache with no known cause
- 27. Whereas; stroke isa global epidemic that threatens lives, health and quality of life Whereas; much can be done to prevent and treat stroke, and rehabilitate those who suffer from one Whereas; professional and public awareness is the first step to action.
- 28. Stroke - anon-communicable disease Attacks 15 million people worldwide every year Claims a life every six seconds – Can be beaten - effectively
- 29. Regardless of age,stroke can strike anyone at any time Stroke can be prevented Stroke survivors can regain their quality of life with appropriate care and long-term support
- 30. Reduce the numberof people who are affected by stroke Reduce the number who die Increased the number who recover Increase the QOL of those who became disable
- 31. The lifetime riskof stroke is 1 in 5 for women, 1 in 6 for men The Lancet Neurology 6(12), 1106-14
- 32. Increase understanding ofthe solutions that exist Knowledge Healthy environment / Healthy behavior Raise awareness
- 33. Translate knowledge intoaction Transdisciplinary team Evidence > Practice Establish simple but comprehensive stroke units
- 34. Generate a movement thatstimulates collective responsibility and action
- 35. 1. Whereas; strokeis a global epidemic that threatens lives, health and quality of life. 2. Whereas; much can be done to prevent and treat stroke, and rehabilitate those who suffer from one. 3. Whereas; professional and public awareness is the first step to action.
- 36. The growing epidemic Growing epidemic > Preventable Joint forces to prevent stroke p The same few risk factors accounts for the health problems Ensure what we know becomes what is done
- 37. The growing epidemic Recognized the uniqueness of stroke Tx & prevent VCI Build Transdisciplinary team
- 38. The growing epidemic Strokeis PREVENTABLE But rising Globally Aging, unhealthy diets, tobacco use, and physical inactivity fuel a growing epidemic >>
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- 42. The growing epidemic High BP High Cholesterol of >> Obesity Diabetes stroke Heart disease VCI
- 43. A treatable andpreventable catastrophe
- 44. o1 Here are 6 steps anyone can take to reduce the risk and the danger of stroke g 1. Know your personal risk factors - BP - Diabetes - Cholesterol
- 45. o1 Here are 6 steps anyone can take to reduce the risk and the danger of stroke g 2. Be physically active and exercise regularly 3. Avoid obesity by keeping to a healthy diet 4. Limit alcohol consumption
- 46. o1 Here are 6 steps anyone can take to reduce the risk and the danger of stroke g 5. Avoid cigarette smoke, if you smoke, seek help to stop now 6. Learn to recognized the warning signs of stroke
- 47. o2 Time lost is Brain function lost Time window of opportunity to treat stroke short once symptoms appears any one having a stroke immediately
- 48. o2 Time lost is Brain function lost Call local Emergency phone no. Go to nearest hospital Even symptoms disappear It may the last opportunity to prevent a potentially forthcoming major stroke
- 49. o3 Disability in adult worldwide Physiotherapy Occupational therapy Rehab
- 51. Transient ischaemic attacks(TIAs) offer a great opportunity to initiate treatments that prevent strokes
- 52. Typical symptoms Hemiparesis Hemisensory loss Dysarthria D th i Diplopia Monocular blindness Ataxia
- 53. Following are NOTTypical symptoms Altered consciousness or syncope Dizziness, wooziness, or giddiness Impaired vision (“grey out”) with alteration of I i d i i (“ t”) ith lt ti f consciousness Amnesia or confusion alone Tonic and/or clonic motor activity Purely sensory symptoms,
- 54. Following are NOTTypical symptoms Sensory march Focal positive neurological symptoms Bowel or bladder incontinence B l bl dd i ti Vertigo, diplopia, dysphagia, or dysarthria
- 55. PX are notbenign Stroke and TIA are both serious conditions both are markers of current or impending disability and a risk of death 10 to 20% of patients have a stroke in the next 90 days, In 50% stroke within the first 24 to 48 hours
- 56. PX are notbenign Between 30% and 50% of TIA patients who undergo brain MRI with diffusion- weighted imaging
- 57. D/DX Non-Focal symptoms Loss of consciousness Faintness Generalised weakness Vertigo only Drop attacks Episodes of ‘confusion’
- 58. Risk score ABCD2 Age≥ 60 years (1 point) BP≥ 140/90 mmHg (1 point) g( p ) Unilateral weakness (2 points) Speech impairment (1 point) Duration ≥ 60 minutes (2 points) or 10–59 minutes (1 point) Diabetes mellitus (1 point)
- 59. Risk score ABCD2 Lowrisk (0–3 points) Moderate risk (4–5 points) ( p ) High risk (6–7 points
- 60. Back to the Bk – t - th - wall ll emergency
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- 63. MI v Stroke Extreme pain, fear of death No pain, Sx are played down p Pt screams for help Pt does not ask for Help Rapid alarm for EMS Bypass of EMS, primary care Physician Good Mx structure & logistic Structure in development
- 64. Imaging guideline Suspected TIAor stroke, urgent cranial CT (Class I), or alternatively MRI (Class II), Level A) If MRI - DWI and T2*-weighted (Class II, Level A) TIA, minor stroke, or early spontaneous recovery, Ultrasound, CTA, or MRA (Class 1I, Level A)
- 65. ESO | AHA/ASA guidelinesdo not separate the management of TIA from ischaemic stroke. Loading dose of aspirin (160-325 mg) within 48 hours of ischaemic stroke (ESO Class I, Level A). No other antiplatelets or combinations (Class III, Level C) Aspirin 50-325 mg/d, aspirin and extended-release dipyridamole, and clopidogrel monotherapy (AHA/ESO Class I, Level A).
- 66. ESO | AHA/ASA guidelinesdo not separate the management of TIA from ischaemic stroke. The combination of aspirin and extended-release dipyridamole over aspirin alone (Class I, Level B) Clopidogrel is recommended over aspirin alone Cl id li d d ii l (Class IIb, Level B), For patients allergic to aspirin (Class IIa, Level B)
- 67. IV rt-PA within4.5 hours (Class I, Level A) BP of 185/110 mmHg or higher IA rTPA acute MCA occlusion within a 6-hour IV streptokinase - not recommended
- 68. Acute Stroke | General IV - rTPA 3-4.5H IA - <6 H Anticoagulation Antiplatelets Aspirin should not be considered a substitute for other acute interventions
- 69. In acute setting Secondaryprevention Drug Tx
- 70. Acute setting 140– 180mg Secondary prevention HbA1C < 7
- 72. Anti lipid Statin /Niacin
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- 75. BMI 18.5 –25.4 Waist : <35 F and < 40 M
- 76. physical activity, at least30 minutes
- 77. Interventional approach Stroke >6 month with 70-90% stenosis > CEA Recent stroke with 50-69% stenosis > CEA <50% Med Tx
- 78. Interventional approach ICAS withsymptoms Stent / angioplasty unceretain
- 79. CardioEmbolic AF – Anticoagulation MIwith mural thrombus Anticoagulation ( 9-12 months) ASA for MI Cardiomyopathy > anticoagulation / ASA Valvular heart disease with or without AF > Anticoagulation without ASA
- 80. CardioEmbolic MAC with regurgiationwith or without AF > Antiplatelet or Anticoagulation Prosthetic valves > anticoagulation
- 81. NonCardioEmbolic > Antiplatelet Arterial dissection Anticoagulation– 3-6 m or Antiplatelet Beyond 6 m > Antiplatelet PFO Antiplatelet
- 82. NonCardioEmbolic > CVT withor without Hg Anticoagulation for 3-6 months followed by Antiplatelet only
- 83. NonCardioEmbolic > Hyperhomocysteinemia B6 B12 & Folate Hypercoagulable state Inherited Thrombophilias CVT > Antiplatelet Recurrent > Anticoagulation
- 84. NonCardioEmbolic > APL Ab> Antiplatelet > APL syndrome > Anticoagulation
- 85. lower-risk > UFH/ LMWH 1st trimester > ASA low dose High risk PG UFH throughout
- 86. After ICH SAHSub Hg > All anticoagulant – stopped for 1-2 wk Resume 3-4 wk Hemorrhagic transformation of Infarct Anticoagulation may be >>
- 87. CAM No current recommendationof neuroprotective substances (Class I, Level A)
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- 90. Drop your QUERY> www.strokeday.50webs.com