Risk factors for stroke

STROKE REHABILITATION

Definition:

¨ A stroke, or cerebrovascular accident (CVA), is an infarction of the brain in which ischemia or hemorrhage causes disruption of function lasting for more than 24 hours. Characterized by sudden onset focal neurological deficit, hemiparesis is the hallmark of stroke. OR

¨ An acute neurologic dysfunction of vascular origin with sudden (within seconds) or at least rapid (within hours) occurrence of symptoms and signs corresponding to the involvement of focal areas in the brain (symptoms and signs > 24 hours) (WHO)

¨ The terms CVA and stroke are generally used interchangeably. To avoid confusion, use description such as right CVA with left hemiparesis.

FIVE MAJOR FUNCTIONS OF STROKE REHABILITAION

1) Prevention, recognition, and management of co-morbid illness and intercurrent medical complications

2) Training for maximal functional independence

3) Facilitating psychosocial coping and adaptation by the patient and family

4) Promoting community reintegration, including resumption of home, family, recreational, and vocational activities

5) Enhancing quality of life

OVERVIEW OF STROKE

- Every 3 minutes someone dies of a stroke

- Every 45 seconds someone in the US has a stroke

- Stroke is the second most frequent cause of disability, second only to arthritis

- Is the 3^rd most common cause of death in developed countries behind cardiovascular disease and cancer

- 730000 new or recurrent strokes occur per year in the US

- About 150000 die each year within one month after the stroke

- The incidence of stroke is age related, with the rate increasing 9 fold between the ages of 55 and 85

What are the most common causes of death in patients admitted to the hospital with a stroke?

The leading causes of death in the first month after a stroke are:

a. The neurologic sequelae of the stroke

b. Pneumonia

c. Pulmonary embolism

d. Cardiac disease

An essential part of stroke treatment is therefore the treatment and prevention of medical complication

RISK FACTORS FOR STROKE

Non-modifiable	Modifiable	Potentially Modifiable
Age Gender Genetic predisposition Race/ethnicity	Hypertension Cardiac disease (e.g., atrial fibrillation) Diabetes Lipids Cigarette smoking Asymptomatic carotid stenosis Sickle cell disease Transient ischemic attack (TIA)	Obesity Physical inactivity Heavy alcohol use Hyperhomocysteinemia Drug abuse Hypercoagulability states Antiphospholipid antibody Factor V Leiden Prothrombin 20210 mutation Protein C deficiency Protein S deficiency Antithrombin III deficiency Hormone replacement therapy Oral contraceptive use Inflammatory processes

4 When faced with a patient with a recent stroke, transient ischemic attack (TIA), or asymptomatic bruit, the clinician must be concerned about the presence of coronary heart disease (CHD). Similarly, any patient who presents with known heart disease and chronic atrial fibrillation should be considered a candidate for stroke prophylaxis.

4 Thirty five percent of people who experience a TIA will have a stroke within 5 years

What is the strongest simple risk factor for stroke?

Age is the strongest simple risk factor. About 30% of strokes occur before the age of 65; 70% occur in those 65 and over. Stroke risk doubles for every decade of age after 55 years

Дата добавления: 2015-10-30