Stroke Dr Jane Molloy Clinical Lead Stroke Services
- Slides: 25
Stroke Dr Jane Molloy – Clinical Lead Stroke Services SRFT
Stroke Background: What is a stroke? How do we ‘know’ there’s a stroke? Why do people have strokes? What can we do to prevent a stroke? What should we do – is there any treatment? Salford Stroke Services
What is a stroke? • Brain is the ‘control centre’ – – – – – Planning Thinking Movement Sensation Memory Balance Speech Language Hearing, vision
What is a stroke? • Delivery of oxygen, glucose • Taking away ‘waste’
What is a stroke? 8 out of 10 due to blood clot 2 out of 10 due to bleeding
How do we ‘know’ there’s a stroke? FAST Video
How do we ‘know’ there’s a stroke? SUDDEN loss of function what is lost depends on which blood vessel is affected we can only tell if there was bleeding by doing a scan Loss of: power = movement feeling = numbness vision = one eye / to one side balance speech – slurring vs wrong words blackout unusual
How do we ‘know’ there’s a stroke?
Is Stroke Important? • 1 stroke every 5 minutes – England & Wales • 3000/year Greater Manchester • 50% dead or disabled at 6 months • 1: 4 of those living >80 years • In women – 3 x deaths from breast cancer 2002
How can we prevent a stroke?
Modifiable Risk Factors Risk factor High Blood Pressure Smoking Ischaemic Heart disease Cholesterol Diabetes Excess alcohol Physical inactivity Weight/diet Excess stroke risk 4– 6 1. 5 – 4 3– 4 *Unclear 2 5 1. 6 – 3. 3 Variable
Blood Pressure • • • Blood pressure <140/85 BP gets higher with age Reduce salt Reduce weight Tablets Self monitoring
Smoking • Don’t! • Smoking cessation – advice & support – signposting
Cholesterol • What’s yours? • Statins reduce death from heart attack and stroke by 1/3 • Dietary changes can help cholesterol but not always
Atrial Fibrillation
Weight & Diet
Exercise • • • Controls weight Improves cholesterol Prevents diabetes Improves mood and helps depression Improves energy levels Improves sleep Improves sexual function Is fun Why don’t we do it?
Preventing Strokestroke
And if despite all that. . • Admit to a hospital with a specialist stroke unit • Urgent brain scanning and assessment • Clot busting treatment if possible – Time is Brain • Stroke Unit Care
Stroke Services – Greater Manchester From this… 2006
To this…from 2010 Salford Bury All others Stockport
30 Day Mortality Over Time 30 25 20 % of patients who died within 30 days 15 10 5 0 Year of Audit 2004 2006 2008 2010
Life After Stroke • Rehabilitation – In hospital – Early Supported Discharge – Community rehabilitation • Life after Stroke Care • Secondary Prevention
Stroke at SRFT • 8 consultants • Service for Greater Manchester • 24/7 acute specialist stroke assessment – Specialist nurses & Drs • >500 patients thrombolysed • Daily TIA clinics – direct referrals
Thank you Questions?
- Mason and molloy classification
- Anterior stroke vs posterior stroke
- Leischker
- Lead magnesium niobate
- National stroke audit rehabilitation services
- Frontage clinical services secaucus nj
- Integrated clinical services management
- Clinical research support services
- Diffserv vs intserv
- Wake county human services community services center
- Stroke and turn
- Participle brush stroke examples
- Appositive brush stroke
- The little decoration at the end of a letter stroke is a
- Back orifice, bifrost, onapsis bizploit are examples of:
- Stokes theorem examples
- Co = hr x sv
- Kelly kasteel
- Brain edema stroke
- Hormetonia
- Pressure-volume loop
- Ejection fraction vs stroke volume
- Frontal lobe stroke
- Stroke recovery stages
- Stroke classification
- Stroke precautions nursing