Anatomy Sign Symptoms of Stroke - The Stroke Network of ...

Anatomy, Signs andSymptoms of StrokePamela Bart,RN. MSc. . ACNPSoutheasternOntario RegionalAcute Care StrokeCNS/NP

Overview• Definition ofstroke• Definition of TIA• Functioning of thebrain• Factors thatdetermine strokeseverity• Recovery fromstroke• Effects of Stroke• Recognizing signsand symptoms ofstroke• Reacting to signsand symptoms ofstroke• Stroke riskFactors (lifestyleand conditions)

The Anatomy of Stroke

Stroke• A sudden injury to a part of the braincaused by an interruption in its bloodsupply• Occurs when a blood vessel bringingoxygen and nutrients to a part of thebrain:• Becomes clogged (ischemic stroke) or• Bursts (hemorrhagic stroke)T & T page 5 & 6

Blood Vessel Becomes Clogged(Ischemic Stroke)

Ischemic Stroke

Ischemic Stroke

Blood VesselBursts(HemorrhagicStroke)

Hemorrhagic Stroke

TIA (Transient Ischemic Attack)• A mini-stroke caused by a temporarilyblocked blood vessel• Symptoms usually last only a few minutes• Can be an important warning sign that aperson may have a stroke in the future• TIA comes before a stroke in some cases• TIAs should never be ignored

The brain functions…Like a computer centre, controlling our:• Personality• Emotions• Behaviour• Movement and coordination• Sensation (touch, temperature, pain andperception of movement/position)• Vision• Perception (ability to accurately interpret whatwe see)• Memory, problem-solving and reasoning• Communication (speaking and understanding) andSwallowing• T & T page 9

• 2 HemispheresBrain Anatomy• Cerebral Cortex (moving, feeling,thinking, speech, vision, complextasks)• Sub-cortical structures (manyfunctions outside of consciouscontrol)• Brain stem and cerebellum (controlsvital functions and coordination)

SOMATOSENSORYHOMONCULUS

Factors that Determinethe Effect of a Stroke• Location of damage• Severity of damage• How well the body repairs the bloodsupply to the brain• How quickly other areas of brain tissuetake over the work of the damaged cells

Recoveringafter aStroke

Recovery• The most rapidrecovery occursduring the first 3 to4 months• Recovery maycontinue over manymonths or years

RecoveryRecovery process is affected by the:• Survivor's age and general health• Survivor's personality• Survivor's coping abilities andemotional state• Support of family and loved ones

Effects of Stroke• Effects can be long- lasting andvary widely• Approximately 50% of the peoplewho have a stroke will have somedegree of long-term disability

Signs and SymptomsRecognize & React

Recognize Signs and Symptoms of StrokeSUDDEN• weakness, numbness and/or tingling in theface, arm or leg(usually one sided).• loss of speech or trouble understandingspeech• loss of vision, particularly in one eye, ordouble vision• severe and unusual headache, or change inthe pattern of headaches• loss of balance, dizziness, unsteadiness orsudden falls, especially with any of the abovesigns.

SCENARIOSSigns andSymptoms ofStroke

Left Hemisphere StrokeRefer to T & T page 9View video clipIdentify effects of stroke• Movement• Sensation• Understanding andExpressing speech• Vision

Right Hemisphere StrokeRefer to T & T page 9View video clipIdentify effects of stroke:• Movement• Sensation• Speech• Vision loss• Awareness of Left side

Posterior brain (brain stem)strokeRefer to T & T page 9View video clipIdentify effects of stroke:• Movement• Balance/coordination• Speech• Vision• Other symptoms

REACT to Signs and Symptomsof Stroke• Recognize symptoms• Record time of onset or time lastseen well• Community stroke: dial 911

REACT to Signs and Symptoms of Stroke• LTC facility: Followinstitutions policy:• Inform RN/RPN in charge• Action taken will dependon client’s advanceddirectives, or directionsfrom power of attorneyfor personal care

Stroke Risk• The risk of stroke for individualswith TIA is 5% in 48 hours , 8%within 1 month and 12% within 1year• Approximately 25% of StrokeSurvivors experience a recurrentstroke within 5 years

Stroke Risk Factors• Cigarettesmoking• SedentaryLifestyle• Alcohol abuse• Unhealthy diet• ObesityLifestyle

Stroke Risk Factors: Conditions• High Blood Pressure• Diabetes• High Cholesterol• Heart and/or valve disease• Heart Failure• Atrial Fibrillation• Carotid Artery Stenosis• Family History• Coagulation Disorders• Psychological Factors

Why do I need to knowsigns and symptoms ofstroke?

Increase myunderstandingof problemsexperiencedby residentswho have had astroke

Enable me totake actionsto helpresidentswho havehad a stroke

Help me to improvecare for residentswho have had a stroke