Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence BRAIN ATTACK - STROKE By: Saleem Ahmed Sangi ( )

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Objectives  Define Stroke  List types of Strokes  List risk factors for Stroke  Identify the signs and symptoms of Stroke  Treatment  Stroke in BI  Importance of Stroke in Pakistan

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Stroke Statistics  Every 3.1 minutes someone dies of a stroke  Stroke risk increases with age. For each decade after age 55, the risk of stroke doubles.  72% of all strokes occur in people over the age of 65

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence What is a Stroke?  Brain tissue is damaged from a sudden loss of blood flow, resulting in a loss of neurological function  Causes: –Blockage (blood clot) occurring inside a blood vessel –Blood vessel leaks blood due to rupture

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Types of Strokes  Ischemic Stroke (87%)  Hemorrhagic Stroke (13%)

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Ischemic Stroke  Types of Ischemic Stroke –Embolic Stroke Blood clot travels to the brain –Thrombotic Stroke Blood flow is blocked to the brain

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Hemorrhagic Stroke  Bleeding occurs from vessels within the brain.  Types of Homorrhagic Stroke –intracerebral hemorrhage Bleeding occurs suddenly caused by hypertension –subarachnoid hemorrhage bleeding occurs between the brain and the meninges (the membrane that covers the brain)

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Transient Ischemic Attacks (TIAs)  A stroke-like event lasting minutes, or hours, that occurs when the brain is deprived of oxygen-rich blood temporarily, but in which the effects wear off completely after the blood- flow returns  TIA’s do not result in permanent brain damage  TIA is serious and too often ignored

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence PLEASE… Pay Attention to these symptoms  TIA’s should not be ignored –More that 1/3 of people will go on to have an actual stroke –5% of strokes will occur within 1 month of the TIA or first stroke –12% will occur within 1 year –20% will occur within 2 years –25% will occur within 3 years

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence  Stroke affects people of All Ages All Ethnic Groups All Backgrounds  Most strokes are preventable, take steps NOW to reduce having a stroke! Stroke does not Discriminate

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Signs & Symptoms of Stroke  Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body  Sudden confusion, trouble speaking or understanding  Sudden trouble seeing in one or both eyes  Sudden trouble walking, dizziness, loss of balance or coordination  Sudden, severe headache with no known cause

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Strokes occur in the brain and affect the opposite side of the body

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Everyone…  Please stand up If you answer yes to any of the following questions, please sit down Thank you

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Risk Factors for Stroke  Blood Pressure over 120/80?  Smoker – exposed to tobacco?  Overweight?  Diabetes?  High Cholesterol?  Heart Disease?

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Risk Factors for Stroke  Family History of Stroke?  Physical activity…less than a total of 30 minutes on most days?  Man over age of 45, OR a woman over 55 years of age?

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Are you sitting down?  Yes, you are at risk for a stroke, but it doesn’t mean you will have one  There are risk factors that can be controlled and risk factors that cannot be controlled

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Risk Factors  Risk factors you can control: –DIET - How we eat, do we follow our diet? –EXERCISE - Do we exercise or get some physical activity? –MEDICATIONS - Taking medications correctly –SMOKING - Stop smoking

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Strokes can affect different parts of the brain, this results in patients experiencing different symptoms

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Recognize the Symptoms of a Stroke  3 Simple Questions –Ask the person to smile –Ask the person to raise both arms –Ask the person to say a simple sentence “The sky is blue in Karachi” The sky is blue in Boston

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence tPA (Tissue Plasminogen Activator) –is a clot-busting drug –Ischemic strokes, the most common type of strokes, can be treated with a drug called t- PA, that dissolves blood clots obstructing blood flow to the brain.

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Medications  Aspirin  Aggrenox  Plavix  Blood pressure medication if appropriate  Cholesterol lowering medicines if needed

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Use Of BI

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence EKG – may show atrial fibrillation

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Carotid Ultrasound – will show if there is stenosis (narrowing of the blood vessel)

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Chest X-ray

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Blood work - Labs  Any labs may be ordered, Lipid Profile (checking your cholesterol level) is done on all patients.

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence TIME IS BRAIN  Time is very important in order to receive this medication  Window of opportunity to start treating stroke patients is three hours, but to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes.

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Stroke in Pakistan  Incidence of stroke in US is about 200 patients per 100, 000 population. In Pakistan, it is believed to be even higher.  A national health survey revealed that more than 30% population above age 45 is suffering from high BP  12% population above age 15 is suffering from high cholesterol

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Cont..  5 million diabetics in Pakistan (#6 in world ranking). It is estimated that there will be 13 million diabetics in Pakistan by 2020 (#4 in world).  Estimated stroke incidence in Pakistan is close to 250 per 100,000 population, which means that there are 350,000 new stroke patients every year in this country. , Pashtuns have the highest prevalence of high blood pressure and stroke.

Ask for a smile Ask for a stretch The sky is blue in Boston Ask for a sentence Can you SPOT a Stroke? –Do you have any questions?? THANK YOU….