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Brain Attacks: Stroke, tBA, TSA
| Course Number |
LWH510
3064 |
| Objectives |
At the end of this course, you will |
| Credit Hours and Fee |
3.0 CE Credit Hours with a fee of $24.00 |
| Instructor |
Rudolf Klimes, PhD (Indiana University), MPH
(Johns Hopkins University);
Adjunct Professor at Folsom Lake
College, Folsom CA. |
|
Welcome
to this
3-contact-hour Continuing Education course with instant online processing and
certification 24/7. Study the course below, take the 12-question
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soon as you finish.
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click here..
You may retake the test once.
|
A. The
symptoms of stroke:
- Sudden NUMBNESS
or weakness of face, arm, or leg,
especially on one side of the body
- Sudden CONFUSION,
trouble speaking or understanding
speech
- Sudden TROUBLE SEEING
in one or both eyes
- Sudden TROUBLE WALKING,
dizziness, loss of balance or
coordination
- Sudden SEVERE HEADACHE
with no known cause
B. What is Stroke?
A stroke occurs when the blood supply to part of the
brain is suddenly interrupted or when a blood vessel
in the brain bursts, spilling blood into the spaces
surrounding brain cells. Brain cells die when they
no longer receive oxygen and nutrients from the
blood or there is sudden bleeding into or around the
brain. The symptoms of a stroke include sudden
numbness or weakness, especially on one side of the
body; sudden confusion or trouble speaking or
understanding speech; sudden trouble seeing in one
or both eyes; sudden trouble with walking,
dizziness, or loss of balance or coordination; or
sudden severe headache with no known cause. There
are two forms of stroke: ischemic - blockage
of a blood vessel supplying the brain, and
hemorrhagic - bleeding into or around the brain.
Is there any
treatment?
Generally there are three treatment stages for
stroke: prevention, therapy immediately after
the stroke, and post-stroke rehabilitation.
Therapies to prevent a first or recurrent stroke
are based on treating an individual's underlying
risk factors for stroke, such as hypertension,
atrial fibrillation, and diabetes. Acute stroke
therapies try to stop a stroke while it is
happening by quickly dissolving the blood clot
causing an ischemic stroke or by stopping the
bleeding of a hemorrhagic stroke. Post-stroke
rehabilitation helps individuals overcome
disabilities that result from stroke damage.
Medication or drug therapy is the most common
treatment for stroke. The most popular classes
of drugs used to prevent or treat stroke are
antithrombotics (antiplatelet agents and
anticoagulants) and thrombolytics.
What is the
prognosis?
Although stroke is a disease of the brain, it
can affect the entire body. A common disability
that results from stroke is complete paralysis
on one side of the body, called hemiplegia.
A related disability that is not as debilitating
as paralysis is one-sided weakness or
hemiparesis. Stroke may cause problems with
thinking, awareness, attention, learning,
judgment, and memory. Stroke survivors often
have problems understanding or forming speech. A
stroke can lead to emotional problems. Stroke
patients may have difficulty controlling their
emotions or may express inappropriate emotions.
Many stroke patients experience depression.
Stroke survivors may also have numbness or
strange sensations. The pain is often worse in
the hands and feet and is made worse by movement
and temperature changes, especially cold
temperatures.
Recurrent stroke is frequent; about 25
percent of people who recover from their first
stroke will have another stroke within 5 years.
What research
is being done?
The National Institute of Neurological Disorders
and Stroke (NINDS) conducts stroke research and
clinical trials at its laboratories and clinics
at the National Institutes of Health (NIH), and
through grants to major medical institutions
across the country. Currently, NINDS researchers
are studying the mechanisms of stroke risk
factors and the process of brain damage that
results from stroke. Basic research has also
focused on the genetics of stroke and stroke
risk factors. Scientists are working to develop
new and better ways to help the brain repair
itself to restore important functions. New
advances in imaging and rehabilitation have
shown that the brain can compensate for function
lost as a result of stroke.
Source:
|
http://www.ninds.nih.gov/disorders/stroke/stroke.htm
C. Types of Stroke
Ischemic Stroke
An ischemic stroke occurs when an artery that supplies blood and
oxygen to the brain becomes blocked. Most strokes are of this type.
Blood clots are the most common cause of artery blockage. Ischemic
strokes can also be caused by a narrowing of the arteries (called
stenosis). The most common condition that causes stenosis is
atherosclerosis. In atherosclerosis, plaque (a mixture of fatty
substances including cholesterol and other lipids) and blood clots
build up inside the artery walls, causing thickening, hardening, and
loss of elasticity. These lead to decreased blood flow.
Hemorrhagic Stroke
A hemorrhagic stroke occurs when an artery in the brain bursts.
Hemorrhage can occur in several ways. One cause is an aneurysm, a
weak or thin spot on an artery wall that can expand like a balloon.
The thin walls of the stretched artery can rupture or break.
Hemorrhage also occurs when arterial walls lose their elasticity and
become brittle and thin. They can then crack and bleed. This can
happen with atherosclerosis. High blood pressure increases the risk
of a hemorrhagic stroke.
There are two main types of hemorrhagic stroke. An intracerebral
hemorrhage occurs when a blood vessel in the brain leaks blood into
the brain itself. A subarachnoid hemorrhage is bleeding under the
outer membranes of the brain and into the thin fluid–filled space
that surrounds the brain.
Transient Ischemic Attacks
A transient ischemic attack (TIA) is sometimes called a mini–stroke.
It starts just like a stroke but then clears up within 24 hours,
leaving no apparent symptoms or deficits. A TIA is a warning that
the person is at risk for a more serious stroke. Having other risk
factors increases a person's chances of a recurrent stroke if they
have had a TIA. For most TIAs the symptoms go away within an hour.
However, there is no way to tell whether symptoms will be a TIA or a
more serious stroke that can lead to death or disability. The sudden
onset of the symptoms of a stroke should signal an emergency.
Patients and witnesses should not wait to see if the symptoms go
away.
|
| Stroke is the third leading cause of
death in the United States. It is also a leading cause of serious
long term disability. While most strokes occur in people over the
age of 65, strokes can occur at any age.
D. Outcome
Among people who survive, strokes can affect the entire body.
Stroke can leave victims with physical, mental, and emotional
deficits. The amount of disability is related to the severity of the
stroke. People who survive a stroke are also at risk for having
another stroke.
- Physical: Persons who have had a stroke can have
weakness or even complete paralysis on one side of the body. The
paralysis or weakness may affect only the face, an arm, or a leg
or may affect one entire side of the body and face. Some stroke
patients may have trouble with swallowing. Slurred speech due to
weakness of the muscles used in speaking may also occur.
- Activity and balance: A stroke victim may have
problems performing daily activities, such as walking, dressing,
eating, and using the bathroom. Balance and coordination may
also be a problem.
- Cognitive deficits: Stroke may cause problems with
thinking, awareness, attention, learning, judgment, and memory.
- Language: Stroke victims may find it hard to
understand or form speech. This is called aphasia. Aphasia
usually occurs along with problems in reading or writing.
- Emotional: Stroke patients may find it difficult to
control their emotions or may express inappropriate emotions in
certain situations. One common emotional problem with many
stroke patients is depression. Post–stroke depression may be
more than a general sadness resulting from the stroke.
Medications and therapy might be needed to treat the depression.
- Pain: Stroke patients may experience pain,
uncomfortable numbness, or strange sensations after a stroke.
These sensations may be due to many factors including damage to
the sensory regions of the brain, stiff joints, or a disabled
limb.
- Recurrent Stroke: Recurrent stroke is a major
contributor to stroke disability and death, with the risk of
severe disability or death from stroke increasing with each
stroke. The risk of a recurrent stroke is greatest right after a
stroke.
E. Treatment
| Medical treatments can help to
control the risk factors that put people at higher risk for
stroke. These include treating high blood pressure, heart
disease, and diabetes. Lifestyle changes such as quitting
smoking can also lower the risk of stroke. See our section
on Risk
Factors. Acute stroke therapies try to stop a stroke
while it is happening. These treatments try to dissolve the
blood clot causing an ischemic stroke or to stop the
bleeding of a hemorrhagic stroke. These therapies are most
effective when given very soon after the onset of a stroke.
Post–stroke treatment and rehabilitation are used to
lower the risk of another stroke and to help patients
overcome disabilities that result from stroke. People who
have had a stroke can do things to lower their risk of
having another stroke. These include controlling their
underlying risk factors. See our section on
Risk
Factors.
Rehabilitation helps stroke victims relearn skills that
may be lost when the brain is damaged. Rehabilitation may
include the following:
- Physical therapy to help restore movement,
balance, and coordination.
- Occupational therapy to help the patient
relearn everyday activities such as eating, drinking,
dressing, bathing, cooking, reading and writing.
- Speech therapy to help stroke patients
relearn language and speaking skills, including
swallowing, or learn other forms of communication.
- Psychological or psychiatric help after a
stroke. Psychological problems, such as depression,
anxiety, frustration, and anger, can be common after a
stroke.
The best treatment for stroke is the take steps to lower
the risk for stroke. All persons can take steps to lower
their risk for stroke. See our section on
Risk
Factors.
|
F: Stroke Prevention
All people can take steps to lower their risk for stroke,
whether they have had a stroke or not. Things you can do to
lower the risk of stroke include steps to prevent and
control high blood pressure, heart disease, and other
chronic conditions.
Prevent and control high blood pressure: High
blood pressure is easily checked. It can be controlled with
lifestyle changes and with medicines when needed. You can
work with your doctor to treat high blood pressure and bring
it down. Lifestyle actions such as healthy diet, regular
physical activity, not smoking, and healthy weight will also
help you to keep normal blood pressure levels. All adults
should have their blood pressure checked on a regular basis.
See our
high blood pressure fact sheet.
Prevent and control diabetes: People with diabetes
have a higher risk of stroke, but they can also work to
reduce their risk. Further, recent studies suggest that all
people can take steps to reduce their risk for diabetes.
These include weight loss and regular physical activity. For
more information about diabetes, see
CDC's diabetes program
Web site.
No tobacco: Smoking can affect a number of things
that relate to risk of high blood pressure, heart disease,
and stroke. Not smoking is one of the best things a person
can do to lower their risk of stroke. Quitting smoking will
also help to lower a person's risk of stroke. The risk of
stroke decreases a few years after quitting smoking. Your
doctor can suggest programs to help you quit smoking. For
more information about tobacco use and quitting, see
CDC's tobacco
intervention and prevention source Web site.
Treat atrial fibrillation: Atrial fibrillation is
an irregular beating of the heart. It can cause clots that
can lead to stroke. A doctor can prescribe medicines to help
reduce the chance of clots.
See our fact sheet on this condition.
Prevent and control high blood cholesterol: High
blood cholesterol is a major risk factor for heart disease,
which can increase the risk for stroke. Preventing and
treating high blood cholesterol includes eating a diet low
in saturated fat and cholesterol and higher in fiber,
keeping a healthy weight, and getting regular exercise. A
lipoprotein profile can be done to measure several kinds of
cholesterol as well as triglycerides (another kind of fat
found in the blood). All adults should have their
cholesterol levels checked once every five years, and more
often if it is found to be high. If it is high, your doctor
may prescribe medicines to help lower it.
See our cholesterol fact sheet.
Moderate alcohol use: Excessive alcohol use can
increase the risk of high blood pressure. People who drink
should do so in moderation. More information on alcohol can
be found at CDC's
alcohol and public health Web site.
Maintain a healthy weight: Healthy weight status
in adults is usually assessed by using weight and height to
compute a number called the "body mass index" (BMI). BMI is
used because it relates to the amount of body fat for most
people. An adult who has a BMI of 30 or higher is considered
obese. Overweight is a BMI between 25 and 29.9. Normal
weight is a BMI of 18 to 24.9. Proper diet and regular
physical activity can help to maintain a healthy weight. You
can compute your BMI at
CDC's nutrition and physical activity program Web site.
Regular Physical Activity: The Surgeon General
recommends that adults should engage in moderate level
physical activities for at least 30 minutes on most days of
the week. For more information, see
CDC's nutrition
and physical activity program Web site.
Diet and nutrition: Along with healthy weight and
regular physical activity, an overall healthy diet can help
to lower blood pressure and cholesterol levels. This
includes eating lots of fresh fruits and vegetables,
lowering or cutting out salt or sodium, and eating less
saturated fat and cholesterol to lower the risk of high
blood pressure and heart disease which can lead to stroke.
For more information, see
CDC's nutrition
and physical activity program Web site.
Genetic Risk Factors
Stroke can run in families. Genes play a role in stroke risk
factors such as high blood pressure, heart disease,
diabetes, and vascular conditions. It is also possible that
an increased risk for stroke within a family is due to
factors such as a common sedentary lifestyle or poor eating
habits, rather than hereditary factors. Find out more about
genetics and diseases on CDC's
genomics and disease
prevention Web site |
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