NSB231 Lecture Notes - Lecture 3: Transient Ischemic Attack, Calcium Channel Blocker, Stroke
Week 3 – Stroke, Hypertension & PVD Lecture
Hypertension
• National health survey
• 140/90 mmHg defined
• Primary and secondary
• Implication- chronic stress on the heart and vessels
• RASS important regulating blood volume
Secondary Hypertension
• Elevated BP with a specific cause
Interventions (NHRA 2016)
• Calcium channel blockers
• ACE
• Diuretics
• Manage associated conditions
• Lifestyle modifications
• Monitor BP
Stroke (Stroke Foundation)
• Occurs when there is ischemia or haemorrhage into the brain that results in death of brain
cells
• Loss of function varies according to location and extent of brain tissue
• Physical, cognitive, emotional impact of patient.
Stroke Prevention
• Healthy diet
• Weight control
• Exercise
• No smoking
• Limit alcohol
• Routine health assessment
Transient Ischemic Attack (TIA)
• Mini stroke happens when blood supply to brain is interrupted for a short time
• Last less than an hour
• 1/3 will progress to ischemic stroke
• Signs and symptoms
-weakens, numbness
-difficult speaking
-dizziness, loss of balance
-loss of visions, blurred vision
Types of Strokes
1. Ischemic (blockage)
i. Thrombotic
-injury to blood vessel wall and formation of a clot
-progressive, asymptomatic
ii. Embolic
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-moving clot that lodges into an artery
-sudden symptoms and onset
1. Haemorrhagic (rupture)
-sudden onset
-high mortality
-change intercranial pressure
FAST
F- one side of the face drooping
A- arm or leg weakness
S- speech difficulty
T- time of occurrence (IMPORTANT)
Diagnostic Studies
• Confirm that it is a stroke
• Identify the likely cause of the stroke
• Noncontract CT scan and MRI
-indicate the size and location of lesion
-differentiate between ischemic and haemorrhagic stroke
• Other studies
-CTA or MRA
-cerebral angiography
-Transcranial Doppler ultrasonography
Surgical Therapy for TIA/Stroke
• Carotid endarterectomy
• Stenting
• Transluminal angioplasty
• Extracranial-intracranial bypass
Postoperative care is important
• Neurovascular assessment
• BP management
• Assessment of stent occlusion
• Minimize complications at insertion site
Acute Care for Ischemic Stroke
• Goals
-preserving life
Preventing further brain damage
Reducing disability
• The time of onset of symptoms is critical information
• Beings with managing
1. Airway
2. Breathing
3. Circulation
• Baseline neurologic assessment
-monitor closely for ICP, neuro deficit
• Elevated BP is common
• Carefully work to control fluid and electrolyte balance
• Mange ICP
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Week 3 stroke, hypertension & pvd lecture. Hypertension: national health survey, 140/90 mmhg defined, primary and secondary, rass important regulating blood volume. Implication- chronic stress on the heart and vessels. Secondary hypertension: elevated bp with a specific cause. Interventions (nhra 2016: calcium channel blockers, ace, diuretics, manage associated conditions, monitor bp. Stroke (stroke foundation: occurs when there is ischemia or haemorrhage into the brain that results in death of brain cells. Loss of function varies according to location and extent of brain tissue: physical, cognitive, emotional impact of patient. Stroke prevention: healthy diet, weight control, exercise, no smoking. Last less than an hour: mini stroke happens when blood supply to brain is interrupted for a short time, 1/3 will progress to ischemic stroke. Injury to blood vessel wall and formation of a clot. Diagnostic studies: confirm that it is a stroke, noncontract ct scan and mri. Differentiate between ischemic and haemorrhagic stroke: other studies.
