Stroke: A Speaker’s OutlineStroke: A Speaker’s Outline
Developed by:
The American Stroke Association
Developed by:
The American Stroke Association
Updated 4.19.2011
What Is a Stroke?What Is a Stroke?
A brain injury caused when a blood vessel to the brain becomes blocked our bursts, cutting off blood flow
A brain injury caused when a blood vessel to the brain becomes blocked our bursts, cutting off blood flow
What Is Stroke’s Impact? What Is Stroke’s Impact? Stroke is the third leading cause Stroke is the third leading cause
of death in the United Statesof death in the United States
• About 795,000 Americans suffer a About 795,000 Americans suffer a stroke each year (that’s a stroke stroke each year (that’s a stroke every 40 seconds)every 40 seconds)
• 77% are new strokes and 23% are 77% are new strokes and 23% are recurrent strokesrecurrent strokes
• Stroke kills more than 137,000 Stroke kills more than 137,000 people in a year. ( that’s a death people in a year. ( that’s a death every 4 minutes)every 4 minutes)
Stroke is the third leading cause Stroke is the third leading cause of death in the United Statesof death in the United States
• About 795,000 Americans suffer a About 795,000 Americans suffer a stroke each year (that’s a stroke stroke each year (that’s a stroke every 40 seconds)every 40 seconds)
• 77% are new strokes and 23% are 77% are new strokes and 23% are recurrent strokesrecurrent strokes
• Stroke kills more than 137,000 Stroke kills more than 137,000 people in a year. ( that’s a death people in a year. ( that’s a death every 4 minutes)every 4 minutes)
What Is Stroke’s Impact? (cont’d) What Is Stroke’s Impact? (cont’d)
Stroke is a leading cause of Stroke is a leading cause of serious, long-term disability serious, long-term disability
40% of Stroke deaths occur in 40% of Stroke deaths occur in males, and 60% in females.males, and 60% in females.
Americans paid about $73.7 billion Americans paid about $73.7 billion for stroke-related medical costs in for stroke-related medical costs in 20102010
Stroke is a leading cause of Stroke is a leading cause of serious, long-term disability serious, long-term disability
40% of Stroke deaths occur in 40% of Stroke deaths occur in males, and 60% in females.males, and 60% in females.
Americans paid about $73.7 billion Americans paid about $73.7 billion for stroke-related medical costs in for stroke-related medical costs in 20102010
What Are the Types of Stroke?What Are the Types of Stroke?
Ischemic (Blockage) 87%
Caused by a blockage in the blood vessels to the brain
Hemorrhagic (Bleeding) 13%
Caused by burst or leaking blood vessels in the brain
Ischemic (Blockage) 87%
Caused by a blockage in the blood vessels to the brain
Hemorrhagic (Bleeding) 13%
Caused by burst or leaking blood vessels in the brain
What Causes Ischemic Stroke ?What Causes Ischemic Stroke ?
Fatty deposits line the blood vessel wall
•Thrombus: A blood clot forms at the fatty deposit
•Embolus: A travelingparticle gets stuck in a small vessel
Fatty deposits line the blood vessel wall
•Thrombus: A blood clot forms at the fatty deposit
•Embolus: A travelingparticle gets stuck in a small vessel
Clot-caused Stroke by Age, Sex and RaceClot-caused Stroke by Age, Sex and Race
Annual rate of first cerebral infarction by age, sex and race Annual rate of first cerebral infarction by age, sex and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94).(Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94). Source: Unpublished data from the GC/NKSS; Kissela et al., Stroke. 2004;35:426-31.Source: Unpublished data from the GC/NKSS; Kissela et al., Stroke. 2004;35:426-31.
What Causes Hemorrhagic Strokes?What Causes Hemorrhagic Strokes?
A weakened blood vessel rupturesA weakened blood vessel ruptures
Aneurysms:Aneurysms: Ballooning of a Ballooning of a weakened spot of a weakened spot of a blood vesselblood vessel
Arteriovenous Arteriovenous Malformations (AVMs): Malformations (AVMs): Cluster of abnormal Cluster of abnormal blood vessels blood vessels
A weakened blood vessel rupturesA weakened blood vessel ruptures
Aneurysms:Aneurysms: Ballooning of a Ballooning of a weakened spot of a weakened spot of a blood vesselblood vessel
Arteriovenous Arteriovenous Malformations (AVMs): Malformations (AVMs): Cluster of abnormal Cluster of abnormal blood vessels blood vessels
Hemorrhagic Stroke by Age, Sex and Race
Hemorrhagic Stroke by Age, Sex and Race
Annual rate of first intracerebral hemorrhage by age, sex and race Annual rate of first intracerebral hemorrhage by age, sex and race (Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94).(Greater Cincinnati/Northern Kentucky Stroke Study: 1993-94). Source: Kissela et al., Stroke. 2004;35:426-31.Source: Kissela et al., Stroke. 2004;35:426-31.
What Parts of theBrain Can Stroke Affect?
What Parts of theBrain Can Stroke Affect?
What Are the Effects of Stroke?What Are the Effects of Stroke?
Right Brain Right Brain
What Are the Effects of Stroke?What Are the Effects of Stroke?
Left Brain Left Brain
Stroke Warning SignsStroke Warning Signs Sudden weakness or numbness of the
face, arm or leg, especially on one sideof 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 headaches with no known cause
Sudden weakness or numbness of the face, arm or leg, especially on one sideof 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 headaches with no known cause
Learn to recognize a stroke.
Time lost is brain lost.
Learn to recognize a stroke.
Time lost is brain lost. If you notice one or more of
the stroke warning signs,GET HELP IMMEDIATELY!
Stroke is an emergency – CALL 9-1-1.
If you notice one or more of the stroke warning signs,GET HELP IMMEDIATELY!
Stroke is an emergency – CALL 9-1-1.
Transient Ischemic Attacks (TIAs)Transient Ischemic Attacks (TIAs)
TIAs are “warning strokes” that can happen before a major stroke
They occur when blood flow through a brain artery is briefly blocked or reduced
TIAs are “warning strokes” that can happen before a major stroke
They occur when blood flow through a brain artery is briefly blocked or reduced
TIA symptoms are temporary but similar to those of a full-fledged stroke
A person who has a TIA is 9.5 times more likely to have a stroke
A TIA is a medical emergency
TIA symptoms are temporary but similar to those of a full-fledged stroke
A person who has a TIA is 9.5 times more likely to have a stroke
A TIA is a medical emergency
Transient Ischemic Attacks (TIAs)Transient Ischemic Attacks (TIAs)
Stroke Risk Factors That Cannot Be TreatedStroke Risk Factors That Cannot Be Treated Age
Heredity (family history) and race
Sex (gender)
Prior stroke, TIA or heart attack
Age
Heredity (family history) and race
Sex (gender)
Prior stroke, TIA or heart attack
Stroke Prevalence by Age & Sex
Stroke Prevalence by Age & Sex
Prevalence of stroke by age and sexPrevalence of stroke by age and sex (NHANES: 1999-2004). (NHANES: 1999-2004). Source: NCHS and NHLBI.Source: NCHS and NHLBI.
0.5 1.2
6.5
0.5
2.3
6.2
12.414.8
0
2
4
6
8
10
12
14
16
20-39 40-59 60-79 80+
Perc
ent o
f Pop
ulat
ion
Men Women
Stroke Risk FactorsThat Can Be TreatedStroke Risk FactorsThat Can Be Treated High blood pressure
Tobacco use
Diabetes
Carotid or other artery disease
Atrial fibrillation
Other heart disease
High blood pressure
Tobacco use
Diabetes
Carotid or other artery disease
Atrial fibrillation
Other heart disease
Stroke Risk FactorsThat Can Be Treated (cont’d)Stroke Risk FactorsThat Can Be Treated (cont’d) Sickle Cell Disease (Sickle
Cell Anemia)
High blood cholesterol
Poor diet
Physical inactivity
Obesity
Stroke Risk by Levelsof Risk Factors
Stroke Risk by Levelsof Risk Factors
AA BB CC DD EE FFSystolic BP*Systolic BP* 95-10595-105 130-148130-148 130-148130-148 130-148130-148 130-148130-148130-148130-148DiabetesDiabetes NoNo NoNo YesYes YesYes YesYesYesYesCigarettesCigarettes NoNo NoNo NoNo YesYes YesYesYesYesPrior Atrial Prior Atrial Fib.Fib. NoNo NoNo NoNo NoNo Yes Yes YesYesPrior CVDPrior CVD NoNo NoNo NoNo NoNo NoNoYesYes
Estimated 10-year stroke risk in 55-year-old adults according to levels of Estimated 10-year stroke risk in 55-year-old adults according to levels of various risk factors various risk factors (FHS). (FHS). Source: Wolf et al., Stroke.1991;22:312-318.Source: Wolf et al., Stroke.1991;22:312-318.
Less Well-Documented Stroke Risk FactorsLess Well-Documented Stroke Risk Factors
Geographical location
Socioeconomic factors
Excessive alcohol intake
Certain kinds of drug abuse
Geographical location
Socioeconomic factors
Excessive alcohol intake
Certain kinds of drug abuse
How Can You ReduceYour Risk of Stroke?How Can You ReduceYour Risk of Stroke?
Control high blood pressure Don’t smoke Consume less sodium Lower cholesterol Lose excess weight Be physically active
Control high blood pressure Don’t smoke Consume less sodium Lower cholesterol Lose excess weight Be physically active
Other Actions That Will Probably Reduce Stroke Risk
Other Actions That Will Probably Reduce Stroke Risk Limit alcohol intake Don’t use illicit drugs Women who smoke or have a
history of blood clots should not take oral contraceptives
Look for signs of sleep-disordered breathing
Limit alcohol intake Don’t use illicit drugs Women who smoke or have a
history of blood clots should not take oral contraceptives
Look for signs of sleep-disordered breathing
How Are Strokes Treated?How Are Strokes Treated? Ischemic StrokeIschemic Stroke
• Acute treatmentAcute treatment Clot-buster, e.g., t-PAClot-buster, e.g., t-PA Interventional proceduresInterventional procedures
• Preventive treatmentPreventive treatment Anticoagulants (warfarin)Anticoagulants (warfarin) Antiplatelet agents (aspirin) Antiplatelet agents (aspirin) Carotid endarterectomyCarotid endarterectomy Angioplasty/stentsAngioplasty/stents
Hemorrhagic StrokeHemorrhagic Stroke• Surgery Surgery • Endovascular procedures, e.g., “coils”Endovascular procedures, e.g., “coils”
Ischemic StrokeIschemic Stroke• Acute treatmentAcute treatment
Clot-buster, e.g., t-PAClot-buster, e.g., t-PA Interventional proceduresInterventional procedures
• Preventive treatmentPreventive treatment Anticoagulants (warfarin)Anticoagulants (warfarin) Antiplatelet agents (aspirin) Antiplatelet agents (aspirin) Carotid endarterectomyCarotid endarterectomy Angioplasty/stentsAngioplasty/stents
Hemorrhagic StrokeHemorrhagic Stroke• Surgery Surgery • Endovascular procedures, e.g., “coils”Endovascular procedures, e.g., “coils”
RehabilitationRehabilitation If you have a stroke, start a
rehabilitation program as soonas you can
Rehabilitation may focus on:
• Self-care
• Mobility
• Communication
• Cognitive skills
• Social skills
If you have a stroke, start a rehabilitation program as soonas you can
Rehabilitation may focus on:
• Self-care
• Mobility
• Communication
• Cognitive skills
• Social skills
Types of Rehabilitation ProgramsTypes of Rehabilitation Programs Acute care and rehabilitation
hospitals Long-term nursing care facilities At home, through home health
agencies Outpatient facilities
Acute care and rehabilitation hospitals
Long-term nursing care facilities At home, through home health
agencies Outpatient facilities
Rehabilitation SpecialistsRehabilitation Specialists Physicians
Rehabilitation nurses
Physical therapists
Speech/language therapists
Physicians
Rehabilitation nurses
Physical therapists
Speech/language therapists
Rehabilitation Specialists (cont’d)Rehabilitation Specialists (cont’d) Audiologists Audiologists
Occupational therapists Occupational therapists
PhysiatristsPhysiatrists
Psychologists / Psychologists / psychiatristspsychiatrists
Audiologists Audiologists
Occupational therapists Occupational therapists
PhysiatristsPhysiatrists
Psychologists / Psychologists / psychiatristspsychiatrists
Are you a stroke survivor,
caregiver, family member or healthcare provider
who needs information about
stroke?
Are you a stroke survivor,
caregiver, family member or healthcare provider
who needs information about
stroke?
Subscribe to Stroke Connection Magazine
Subscribe to Stroke Connection Magazine
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or visit
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or visit
strokeassociation.org
for a FREE
subscription.
To Learn More About Stroke…To Learn More About Stroke…
CALL 1-888-4-STROKE (1-888-478-
7653)
Or visit us online at StrokeAssociation.org
CALL 1-888-4-STROKE (1-888-478-
7653)
Or visit us online at StrokeAssociation.org