Brain Attack: Stroke
Brain Attack: Stroke
Brain Attack: Stroke
WHAT IS 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; obstruction in blood flow Blood vessel leaks blood due to rupture of artery which feeds the brain
TYPES OF STROKES
Ischemic Stroke (85%)
Ischemic Stroke
Deficiency of blood to the brain caused by an occlusion of an artery from a thrombus or embolism Ischemia deficiency of blood in a part, usually due functional constriction or actual obstruction of blood vessel
ISCHEMIC STROKE
Types of Ischemic Stroke
Embolic Stroke
Blood clot travels to the brain
Thrombotic Stroke
Blood flow is blocked to the brain
HEMORRHAGIC STROKE
Bleeding occurs from vessels within the brain. High blood pressure or a rupture of a blood vessel or an aneurysm may be the cause.
All Backgrounds
Most strokes are preventable, take steps NOW to reduce having a stroke!
Strokes occur in the brain and affect the opposite side of the body
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
Strokes can affect different parts of the brain, this results in patients experiencing different symptoms
Carotid Ultrasound will show if there is stenosis (narrowing of the blood vessel)
Echocardiog ram detects if any thrombus (blood clot) within the heart chambers
CHEST XRAY
ACT IN TIME
Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people's lives and enhance their chances for successful recovery
PRIMARY GOAL
primary goal in treating ischemic stroke is to restore blood flow to the brain. attempted using blood clot-busting drugs such as aspirin, heparin, or tissue plasminogen activators that must be administered within three hours of the stroke.
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.
LIST OF MEDICATIONS
Aspirin Aggrenox Plavix Blood pressure medication if appropriate Cholesterol lowering medicines if needed
DISCHARGE PLANNING
Starts upon admission to the hospital
Consult social worker or care coordinator to help identify discharge needs Provide patient/family with Stroke education
Stroke Support Group meetings
ACT FAST
FACE FACIAL DROOP UNEVEN SMILE ARM NUMBNESS ARM WEAKNESS SLURRED SPEECH DIFFICULTY SPEAKING/ UNDERSTANDING
ARM
SPEECH
TIME
CALL THE NEAREST HOSPITAL AND GO THERE IMMEDIATELY STROKE IS AN EMERGENCY. EVERY MINUTE COUNTS.
- Disabled patients shall be helped by the nurse to sit on dental chair, their airways shall be free and they shall be accompanied by the persons taking care of them, especially if speech difficulties are present;
dentist shall stand in front of the patient, without mask, shall look him in the eyes, shall move slowly and questions shall be simple and clear, for plain answers (yes/no);
- Anamnesis should reveal patients risk factors: if the medical record shows high blood pressure, cardiac diseases, transient vascular accidents, diabetes, dyslipidemia, coronary atheromatosis, (heavy) smoking, old age, then such a patient is prone to stroke and/or myocardial infarction;
- History of past strokes needs to be elicited: date, seriousness, treatment, disabilities. There are situations when patients speech is not affected, but he cannot realize the extent of the palsy (he is not aware of it) or situations when a patient with brain injury on his right side is neglecting his left side of the body; - Blood pressure and pain should be monitored and under control during the entire intervention.
Emergency dental treatment is allowed six months after stroke, it should be performed carefully, by neurologists advice and some precautions are needed, according to the specific characters of the stroke
- If needed, dental treatment produces bleeding (teeth extraction, pulpectomy, subgingival scaling, periodontal surgery), anticoagulant systemic medication may cause serious haemorrhage, therefore anticoagulant drugs like heparin should be stopped at least 6-12 hours before treatment.
Six hours after bleeding, when blood clots are built up, heparin systemic treatment can be resumed. If there is some other anticoagulant medication involved, it should be stopped several hours or days before bleeding dental treatment, after determining the International Clotting Rate (ICR) and decision depends on neurologists advice.
- The dentist should be ready for emergency intervention in case of local hemorrhage, with haemostatic medication and cautery, blood pressure should be monitored and oxygen therapy device is needed in dental office.
The minimal amount of anaesthetic solutions should be injected, concentration of added epinephrine should be very low (1:100.000 or 1:200.000). Use of gingival retraction cord soaked with epinephrine should be avoided.
Metronidazolum and tetracycline should be avoided, since they may affect blood clotting.
- If the patient shows symptoms of stroke, he should get oxygen therapy immediately and should be referred to a hospital as soon as possible. Patients with transient ischemic attack (TIA) or with stroke in their medical record have a very complex dental and periodontal pathology.
If patients show minor physical disabilities after stroke, they can present poor oral hygiene. For such patients, dentists will advise the use of electric toothbrushes, easier to handle, use of dental floss, oral irrigation and prophylaxis using chlorhexydine and fluoride.
GROUP 3 -STROKEAGBAYANI, Cassiopeia CO, Florence JUAN, Faye Ann TESORO, Joseph Paulo VELASCO, Philipp Rey