STROKE: The Brain Matters Module I. Prevalence and incidence:. From 1970s to early 1990s, non-institutionalized stroke survivors increased from 1.5 million to 2.4 million On average, every 45 seconds someone in the U.S. has a stroke
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K:\STROKE CENTER\Staff Learning Opportunities\eLearn\MOD1 (rev. 01.18.08)
Billions of Dollars
Coronary Heart Disease
Estimated Direct and Indirect Costs of Major Cardiovascular Diseases and Stroke
United States: 2006
Source: Heart Disease and Stroke Statistics – 2006 Update
2. A "plug" in its lumen formed by material carried in the blood
3. Abnormally high pressure in brain tissue surrounding the vessel that compresses its wall to the point of squeezing shut its lumen
N Eng J Med 4/17/03
Middle cerebral artery on location
Anterior cerebral artery
Posterior cerebral artery
Aphasia, visual field defects, hemi paresis, hemiplegia, hemi sensory loss, inattention, apraxia.
Diplopia, dysarthria, ataxia, poor motor coordination, vertigo, nausea/vomiting.
Personality changes, confusion, weakness usually> distally, hemiplegia.
Cortical blindness, dyslexia, visual field defects if occipital.
Altered level of consciousness, weakness, numbness.Vessels typically effected and an overview of possible symptoms
Three (3) hour window of time to receive
acute treatment for ischemic stroke.
ED Ischemic stroke pathway:
Exclusion Criteria (Relative Contraindications):
Modified from NINDS criteria
Tissue Plasminogen Activator (t-PA)
Drug class = Fibrinolytic used to treat acute ischemic
stroke. Clot-specific binding to fibrin-bound plasminogen
allowing conversion to plasmin, which digests the fibrin.
Onset of action occurs in 60-90 minutes.
LOADING dose = 0.09 mg/kg IV push over 1 minute (dose
not to exceed 9 mg)
INFUSION dose = 0.81 mg/kg IV infusion over 1 hour (dose
not to exceed 81 mg)
If you think someone may be having a stroke, act F.A.S.T. and do this
TIME LOST IS BRAIN LOST!