Jason C. Zydallis
Raritan Valley Community College
Nursing
What is a Stroke?
o Interruption of blood flow to the brain
resulting in tissue ischemia or death
o Commonly known as a “Brain Attack”
o Strokes are Medical Emergencies!
o Brain cells begin to die from lack of oxygen
o The extent of disability is dependent on the area of the
brain involved.
o Early Treatment is key to decreased disability
Stroke Statistics
o Each year 700,000 Americans suffer a stroke
o Stroke is the 3rd leading cause of death among
cancer and heart disease
o Stroke accounts for more serious long term
disabilities than any other disease
o Highest risk after age 65, however, the risk of
stroke doubles each decade after 55
o Stroke is more common in men especially
African Americans.
Types of Strokes
o Ischemic stroke – restriction of blood supply to the brain
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resulting in inadequate oxygen
Two types : Thrombotic and Embolic
Thrombotic strokes result from developing a clot usually
due to vessel narrowing over time
Embolic strokes results when a piece of an existing clot
breaks off and occludes a vessel
Ischemic strokes are the most common types of strokes
Hemorrhagic strokes are the second type of stroke and are
caused by ruptures vessels inside the brain
Normal vs. Occluded Artery
Ischemic 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)
o More commonly known as “Mini Strokes”
o Are considered a warning sign of progressive
cerebro-vascular disease (vessels of the brain)
o Many only last up to an hour but can last for 24
hours
TIA Signs and Symptoms
o Signs: Sudden severe headache with no known cause
o Temporary loss of vision in one eye or double vision
o Numbness or loss of sensation to one or both sides of the
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body
Inability to speak
Dizziness
Facial drooping
Difficulty walking
Difficulty swallowing
These are not normal occurrences. Seek Emergency Care!
If untreated symptoms may resolve, but can progress to a
full blown stroke!
Nonmodifiable Risk Factors
These are the factors that we have no control over but
may increase the risk of stroke
 Age – Over 65 stroke increases
 Gender – Men have increased risk but women have
an increased mortality rate
 Race – African Americans have increased risk
 Family 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 Factors
o These factors are controllable and prevent the risk of
stroke
o High Blood Pressure – alone is the highest risk for stroke and
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is the least recognized (50% increase in risk)
Heart Disease – Atrial Fibrillation the most common
arrhythmia and most treatable (20% increase in risk)
Diabetes - Increases the risk by 5 times the normal
population for uncontrolled blood glucose
Smoking – Doubles the risk of having a stroke
Cholesterol – High fat diets increase narrowing of the arteries
Obesity – Increases blood pressure, fat molecules in the
arteries, and high blood glucose
Sedentary Lifestyle – Lack of exercise
What do we do to decrease our
risk?
o Addressing our modifiable factors…
o Consume a healthy diet with less fats and increased
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fruits and vegetables also decrease salt intake
Weight Control helps decrease risk for increased blood
pressure
Blood Pressure Control – Check your blood pressure
often and adhere to medicine regimen
Regular exercise – 30mins of walking 3 times per week
has shown great benefit to cardiovascular health
Stop Smoking – Smoking both damages and constricts
vessels in your body
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 expectancy
o Here are some procedures that can decrease the risk of suffering a stroke
o Carotid Endarterectomy – Surgical procedure to manually remove the build up of
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plaque inside of the carotid artery
Carotid Angioplasty – Same day procedure, vessels accessed through your groin and
the artery is opened and stented to ensure positive blood flow
MERCI – mechanical removal of the clot
Anti-platelet drugs – Help decrease the occurrence of clots in high risk patients Ex:
Aspirin, Plavix
Statins – Decreases the cholesterol levels in the blood which may decrease the
buildup of additional plaques in the vessel Ex: Lipitor, Zocor, and Mevacor
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
As you can see there are many options for care as well as following the guide to
prevention of strokes
Lipids and Cholesterol
Sample Lipid/Cholesterol Panel
 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**
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 Pressure
 Blood Pressure should be monitored regularly to ensure normal levels
 Levels should be checked by your MD every visit
 Monitors can be purchased for home usage
Blood Pressure Interpretations
120/80 mmHg – Optimal
140/85 mmHg – Pre-Hypertension
150/90 mmHg – Stage 1 Hypertension
170/100 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 – 25
 Mild Obesity = 25-30
 Obese = >30
Anabolic Steroids and Stimulants
 Increase Blood Pressure further increasing risk for
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stroke
Increase the amount of cholesterol in the blood
Increased fluid retention in the body increases blood
pressure
Stimulants increase pulse and metabolic rate causing
adverse cardiac function
Before 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
consumption
 Affects 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?