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Difference between stroke and MI. Explain why aspirin is not suited for stroke
- Coronary artery can't rupture.
- Stroke could be a result of hemorrhage --> aspirin could elevate the stroke
how does stroke affect brain?
brains require lots of oxygen and can't last very long without it.
Occlusion and Hemmorrhagics
Occlusive strokes: subtypes
thrombotic (in the brain): more common
Embolic(away from the brain): less common
Fatality: occlusive vs hemorrhagic strokes
Hem. stroke is more fatal
Which type of strokes is more likely to happen in dental office? why?
Hemorrhagic strokes and bc of stress
TIA vs strokes: difference
reversible and complete resolution within 24
Stroke - Relative Risk
- --Similar risk factors as for C.A.D : smoking,
- hypertension, diabetes, elevated cholesterol, family history
- --Hypertension carries the greatest
- relative risk
--Valvular heart disease
--Carotid artery disease
--History of previous CVA (20% within 1-2 years)
Stroke - Precipitating Factors: in dental office
In the dental setting, a sudden rapid increase in blood pressure is the greatest precipitating event.
Stroke - Prevention
When to treat? 6 month rule
Confirm that patient took antihypertensive medications
Check the blood pressure
Stress reduction (sedation can mask neurologic symptoms)
Judicious use of epinephrine
Stroke - Recognition: general symptom
Variable (depending on location of cerebral infarct)
Loss of consciousness
Stroke symptoms - recognition: clinical symptom
- Sudden numbness or weakness of
- 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.
Stroke - Treatment
Stop dental procedure
Position patient sitting upright (if conscious) to decrease intracranial pressure.
911—Seconds count. Stroke victims who receive tPA within three hours are 30% more likely to recover with little or no neurologic deficit.
Monitor vital signs
Basic Life Support if needed
Stroke at the emergency room
brain scan --> hemorrhage --> craniotomy to evacuate blood
no blood on brain scan --> receive tPA which dissolve blood clot --> prevent neurologic deficit
stroke pt showed up at hospital with brain scan showing hemorrhage. what's next?
Craniotomy to evacuate blood
Stroke pt showed up at hospital with brain scan showing no hemorrhage. What's next?
administer tPA to dissolve clock
What would you like to do?
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