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STROKE rapidly developing clinical signs disturbance of cerebral…

- - - - Young adults
        
        increase in hospitalization rates (18-54 years)
        
        increase in prevalence of risk factors = all modifiable
        
        address these issues
        
        risk factors for any age
    - - Glial activation - regulate neuroinflammation after stroke
        
        Microglia = sense ischemia and respond
        
        Activated microglia = pro-and anti-inflammatory effects (macrophages and activate astrocytes)
        
        activated astrocytes = pro- and anti-inflammatory effects
        (immediate inflammation response --> pro-regeneration and restore lost function and cells)
        
        Activate oligodendrocytes = impair or promote re-myelination
- - - - most common intial imaging for acute stroke = tell what type of bleed --> to determine tx
    - - eval for acute stroke
      - comprehensive eval
- - - - Anticoagulant = interfere with coagulation cascade (vitamin K)
        
        heparin
        
        warfarin
        
        acute ischemic stroke
        = no added benefit of tx
        
        increased symptomatic intracranial hemorrhages
        
        no evidence of reduced odds of being dependnet or dead at follow-up
        
        data doesnt support routine use of this tx for acute ischemic stroke
      - Antiplatelet = interfere with platelet activation and aggregation (Aspirin)
        
        acute ischemic stroke/TIAs = aspirin is beneficial
    - - For acute ischemic stroke
        
        only FDA approved drug to tx ischemic stroke
        
        needs to be given quickly post stroke (3-4 hours)
    - - beneficial in pts with known CHD/CVD risk/comorbidities
        
        lower stroke incidence in high-risk pts
        
        decrease incidence of CHD in pts with prior stroke
        
        not yet shown to reduced incidence of recurrent stroke
  - - - should be done within 6 hours of the 1st sx of stroke
        
        for clots in larger arteries
        
        catheter aspiration vs. stent retriever
- - - - risk of intracranial hemorrhage
        
        control is critical
        
        benefits dependent on age and medical hx --> anticoagulants + higher age = best benefits