Classification of stroke by etiology and presentation.
Identify risk factors for secondary stroke.
Practical application of guideline recommendations for secondary prevention of stroke.
Pharmacists’ role in preventing stroke reoccurrence.
Stroke is defined as ‘abrupt onset neurological deficit lasting at least 24 hours”. It is the 5th leading cause of death in the United States.
Transient ischemic attack (TIA) is a temporary, brief occurrence of neurological deficit secondary to focal brain, spinal cord or retinal ischemia, and without evidence of acute infarction; with clinical symptoms typically lasting less than one hour
Stroke and TIAs are medical emergencies!
TIA symptoms lasting less than 24 hour with associated infarction found on imaging should be classified as stroke.
Up to 50% of patients that present with TIA may experience stroke within 48 hours , 10- 15 % within 90 days of an episode.
Stroke is responsible for more than 130,000 deaths yearly in the United States, that is one in every twenty deaths.1
Stroke occurs every 40 seconds and every 4 minutes, someone in this country dies of stroke.2
Yearly incidence is about 795,000.
The cost of stroke including cost of care and drugs, missed work days is estimated at $33 billion yearly.2
Over half of survivors have reduced mobility, stroke is a leading cause of disability in survivors ≥ 65 years.
One in four of patients with prior stroke will have a reoccurrence.
By gender, 42 % of men and 24% of women will experience reoccurrence within 5 years on the initial stroke.
Recurrent stroke has a higher rate of disability.
Knowing the primary stroke type is very important, knowledge help drives patient specific secondary prevention measures.
Ischemic Stroke: caused by CLOTS blocking arteries. Step 1- Narrowing of arteries caused by atherosclerosis, or gradual cholesterol deposition.
Step 2- Collection of blood cells in narrowed arteries resulting in formation of blood CLOTS.
Step 3- Clots blocks the artery where they are formed (thrombosis), or travel in the blood and become stuck in arteries nearer to the brain (embolism).