1. 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 (0612118)

2. 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

3. 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

4. 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

5. 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%)

6. 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

7. 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)

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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?

15. 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?

16. 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

17. 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

18. 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

19. 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

20. 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.

21. 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

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

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

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

25. 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)

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

27. 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.

28. 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.

29. 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

30. 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.

31. 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….