fmd chat together 2013 - dr. matthew engelbrecht, stroke & tia

7/29/2019 FMD Chat Together 2013 - Dr. Matthew Engelbrecht, Stroke & TIA

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Stroke and TIA

Dr. Matthew Engelbrecht

Asheville Neurology Specialists


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Objectives

Learn the definition of a stroke and TIA

Understand some of the common

symptoms of strokeUnderstand the mechanisms of stroke in

individuals with FMD


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What is a stroke?

Ischemic stroke

Accounts for 80% of all stroke

Occurs when a blood vessel that carriesnutrients and oxygen to the brain isblocked or closed off

A clot can travel from another part of the

body to the brain or the blood vessels inthe brain itself can gradually become morenarrow


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Hemorrhagic stroke

Occurs when a blood vessel ruptures and

prevents blood flow to the brain Can occur due to aneurysms, vascular

malformations, medications, high bloodpressure, blood clotting disorders, or

spontaneously


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TIA Transient Ischemic

AttackOccurs when a blood vessel is blocked

only temporarily

Can last for a few minutes to severalhours

By definition lasts less than 24 hourstotal

Is not a mini-strokeDoes not lead to any changes on CT or

MRI


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Major risk factors for stroke

Age

History of tobacco use

History of high blood pressureHistory of high cholesterol

History of diabetes


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Stroke facts

About 795,000 individuals suffer a strokeeach year

No. 4 cause of death in the U.S. 40% of stroke deaths occur in males and

60% in females

$73.7 billion annual cost of stroke careand disability


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Stroke data for women

425,000 women suffer stroke each year about 55,000 more than men

Only 27% of women can name morethan 2 primary stroke symptoms

African American and Hispanic womenhave higher stroke rates than Caucasianwomen but are less likely to recognizestroke symptoms and risk factors


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Women are twice as likely to die fromstroke than breast cancer

A survey by the National StrokeAssociation showed that a majority ofwomen surveyed believed that breastcancer was five times more prevalent

than stroke


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Stroke symptoms

Sudden numbness or weakness in the face,arm, or leg especially if occurring only on oneside

Sudden confusion, trouble speaking, orunderstanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss ofbalance, or coordination

Sudden severe headache with no known cause


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Numbness consists of complete orpartial loss of sensation

Weakness consists of loss of strength asopposed to a feeling of heaviness ordecreased endurance

Vision changes can consist of loss of

vision in one eye, loss of part of thevision in both eyes, double vision


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Stroke symptoms

Loss of consciousness

Memory loss

Severe nauseaGeneralized weakness

Limb pain


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Stroke symptoms in women

Sudden facial pain

Sudden hiccups

Chest painHeart palpitations


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Dizziness means different things todifferent people

Lightheadedness, swimmy-headedness,head rush feeling, spinning sensation -vertigo, a feeling of imbalance


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FAST

FACE: Ask the person to smile. Doesone side of the face droop?

ARMS: Ask the person to raise botharms. Does one arm drift downward?

SPEECH: Ask the person to repeat asimple phrase. Is the speech slurred or

strange? TIME: If you observe any of these signs,

call 911 immediately.


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Stroke mimics

Migraines

Migraine auras can cause transient stroke-

like symptoms Seizures

Partial seizures do not cause loss ofconsciousness

Low blood sugar


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Stroke in FMD

Data from the US Registry for FMD 19.2% had TIA or stroke

19.0% had experienced an arterial dissection

17% had an aneurysm Overall, the most common presenting symptoms

which led to diagnosis were high blood pressure,headache, and pulsatile tinnitus

Men were more than twice as likely to have a

dissection or an aneurysm Women were more likely to have symptoms related

to disease of the carotid artery

91% of the people in the registry are female


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Arterial dissection

Occurs when a tear develops in theinnermost lining of the blood vessel

Blood then enters the space between theinner lining and the outer lining of thevessel, leading to narrowing of thevessel


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Stroke prevention

Nutrition

Diet rich in fruits and vegetables

Limit cholesterol and fats Avoid foods and drinks with added sugar

Limit alcohol

Fish and lean meats

More plants, fewer animals


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Stroke prevention

Physical activity

regular cardiovascular activity something

you enjoy Some weight work

Medications

Aspirin, Plavix, Aggrenox, blood thinners


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Risk factor control

Blood pressure and blood sugar control

Cholesterol control Regular visits with primary physician

fmd chat together 2013 - dr. matthew engelbrecht, stroke & tia

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