Stroke
Study online at https://quizlet.com/_9kiz0a
A stroke occurs when blood flow to an
area of the brain is interrupted
Types: ischemic (blockage) and hemor- Background stroke
rhagic (bleeding)
87% of all strokes are ischemic
Time is brain: recognize stroke F.A.S.T
(Face, Arm, Speech, Time)
Brain image is needed to differentiate
between ischemic (blockage) vs. hem-
orrhagic (bleeding) usually done within
Prevention and diagnosis of stroke
20 minutes of the patient arriving at the
hospital
Brain imaging procedures computed to-
mography (CT) or magnetic resonance
imaging (MRI)
Ischemic stroke is due to a blockage in a
vessel
Cause: thrombosis (plaque build up)
Types: cardioembolic and non-cardioem- Ischemic stroke background
bolic
Ischemic cardioembolic stroke: caused
by clot that originated from the heart that
travels to the brain (mainly due to Afib)
Ischemic non-cardioembolic stroke:
caused by a clot originating in the brain;
the term indicates the origin of the dis-
ease in the brain not heart
TIA: caused by temporary clot in the
brain the blocks blood flow; warning of a
future stroke
, Stroke
Study online at https://quizlet.com/_9kiz0a
What is the difference between transient Ischemic stroke: permanent clot
ischemic attack TIA vs ischemic stroke?
Both are medical emergencies
Restore blood flow and prevent brain
What is the goal treatment for ischemic damage
strokes?
Done by removing clot
What is the only FDA approved fibrinolyt-
Alteplase (Activase; Cathflo Activase)
ic agent used in acute ischemic stroke?
Only FDA approved drug for acute is-
chemic stroke
MOA: recombinant tissue plasminogen
activator (tPA) that binds to fibrin in a
thrombin and converts entrapped plas-
minogen to plasmin resulting in fibrinol-
ysis
Alteplase
CI: active bleeding, BP > 185/110, head
injury/stroke within the past 3 months
Warning: major bleeding, cholesterol
embolization (rare), angioedema
Mx: BP and neurological assessments
--> every 15 minutes during the infusion
and for 2 hours after then every 30 min-
utes for the next 6 hours, then hourly until
24 hours after treatment
Alteplase patient criteria
1. in order to use must rule out hemor-
rhagic stroke first through brain imaging
CT scan
2. FDA directions: use within 3 hours of
symptom onset
Study online at https://quizlet.com/_9kiz0a
A stroke occurs when blood flow to an
area of the brain is interrupted
Types: ischemic (blockage) and hemor- Background stroke
rhagic (bleeding)
87% of all strokes are ischemic
Time is brain: recognize stroke F.A.S.T
(Face, Arm, Speech, Time)
Brain image is needed to differentiate
between ischemic (blockage) vs. hem-
orrhagic (bleeding) usually done within
Prevention and diagnosis of stroke
20 minutes of the patient arriving at the
hospital
Brain imaging procedures computed to-
mography (CT) or magnetic resonance
imaging (MRI)
Ischemic stroke is due to a blockage in a
vessel
Cause: thrombosis (plaque build up)
Types: cardioembolic and non-cardioem- Ischemic stroke background
bolic
Ischemic cardioembolic stroke: caused
by clot that originated from the heart that
travels to the brain (mainly due to Afib)
Ischemic non-cardioembolic stroke:
caused by a clot originating in the brain;
the term indicates the origin of the dis-
ease in the brain not heart
TIA: caused by temporary clot in the
brain the blocks blood flow; warning of a
future stroke
, Stroke
Study online at https://quizlet.com/_9kiz0a
What is the difference between transient Ischemic stroke: permanent clot
ischemic attack TIA vs ischemic stroke?
Both are medical emergencies
Restore blood flow and prevent brain
What is the goal treatment for ischemic damage
strokes?
Done by removing clot
What is the only FDA approved fibrinolyt-
Alteplase (Activase; Cathflo Activase)
ic agent used in acute ischemic stroke?
Only FDA approved drug for acute is-
chemic stroke
MOA: recombinant tissue plasminogen
activator (tPA) that binds to fibrin in a
thrombin and converts entrapped plas-
minogen to plasmin resulting in fibrinol-
ysis
Alteplase
CI: active bleeding, BP > 185/110, head
injury/stroke within the past 3 months
Warning: major bleeding, cholesterol
embolization (rare), angioedema
Mx: BP and neurological assessments
--> every 15 minutes during the infusion
and for 2 hours after then every 30 min-
utes for the next 6 hours, then hourly until
24 hours after treatment
Alteplase patient criteria
1. in order to use must rule out hemor-
rhagic stroke first through brain imaging
CT scan
2. FDA directions: use within 3 hours of
symptom onset
