Stroke S24 PDF

NERVOUS DISORDERS: STROKE Kainath, Katia, Manjeeta  WHAT IS A STROKE? Strokes happen when the blood flow to the brain is blocked or there is sudden bleeding in the brain. There are two main types of strokes -: INTRODUCTION 1. Ischemic s...

NERVOUS DISORDERS: STROKE Kainath, Katia, Manjeeta  WHAT IS A STROKE? Strokes happen when the blood flow to the brain is blocked or there is sudden bleeding in the brain. There are two main types of strokes -: INTRODUCTION 1. Ischemic stroke: o Caused by blood vessel blockage affecting brain cells. o Deprives brain cells of oxygen and nutrients. 2. Hemorrhagic stroke: o Caused by burst blood vessel in brain, causing bleeding. o Puts pressure on brain cells, damaging them. (National Heart, Lung and Blood Institute, 2023 Symptoms include weakness, numbness, trouble speaking, and confusion.(Corliss, 2020) WA R N I N G S I G N S A N D ACT FA ST STROKE FACTS Stroke strike every five minutes 100,000 people have stroke each year (Stroke Association, 2024) 3 out of 10 stroke survivors will have a second stroke. 1.3 million stroke survivors in the UK Statistics show around 80% of strokes are preventable. (with health and lifestyle changes) (CLH Healthcare, n.d) Fig 1. (Corliss, 2020)  W HAT CAU SES STRO KE? you're over 50 years old, but it is important to note it can happen to anyone at any age you have genetic conditions such as, sickle cell disease (SCD) you have an unhealthy lifestyle- which includes poor diet, not exercising much, smoking, and heavy alcohol use you have frequent or severe migraines you take the combined contraceptive pill During pregnancy and the period after childbirth- changes in blood flow, hormonal fluctuations. There are also certa in conditions w hich increa se the risk of stroke w hich include: High Blood Pressure (hypertension)- strains blood vessel walls Diabetes- artery damage CAUSE Atrial Fibrillation- irregular heartbeat leading to poor blood flow. High Cholesterol- buildup of fatty deposits in arteries, narrows them (atherosclerosis).  The treatment available depends on the type of stroke you have had. The first 24 hours are very critical and immediate medical attention is required to reduce risk of permanent damage. Initial treatments (first 24hours): 1. Thrombolysis (clot-dissolving medication)- For Ischemic strokes to dissolve blood clots in brain. 2. Thrombectomy- surgically removing blood clot from the brain, often used for larger blood clots. 3. Draining fluid to relieve pressure- Hemorrhagic strokes or when there is brain swelling, fluid can be drained from the brain. Long Term medication for stroke prevention: Anticoagulants- prevents blood blots e.g. TREATM EN T warfarin Blood pressure medications- e.g. propranolol, warfarin Statins- lower your blood cholesterol D E N TA L I M P L I CAT I O N S Oral Health in Patients Hospitalized Because of Ischemic Stroke (Pawlukowska et al., 2024) Oral Motor Dysfunction: Facial paralysis, difficulty swallowing (dysphagia), OH of stroke patients vs control and reduced tongue control group (118) Increased risk of aspiration pneumonia. Speech and effective OH ability Key findings: Medication side effects: Stroke patients had higher mean values Anticoagulants – increased bleeding risk for the Decayed, Missing, and Filled Teeth Xerostomia (dry mouth) (DMFT) Poor OH and Increased caries risk: Higher incidence of dental caries and Motor impairments, cognitive limitations, or neglect worse OH - API and SBI Higher levels of decay, missing teeth, and periodontitis Importance of OH management in stroke Periodontal disease and Stroke risk: rehabilitation Bidirectional relationship D E N TA L T R E AT M E N T M O D I F I CAT I O N S Scheduling and Communication Adjustments: Dental appointments scheduled at least six Adaptive Dental Tools and Techniques: months post stroke. Modified tools; large-handle Morning time and allocating extra time. toothbrushes, electric Effective communication - aphasia (speech toothbrushes, specialised grips, difficulties). suction toothbrushes. Seating at eye level on unaffected side. Prescription fluoride toothpaste Spit to reduce the risk of aspiration. Xerostomia and Dysphagia: Xerostomia management; saliva substitutes, Positioning and Assistance in the increased hydration, sugarless gum, mints, use Dental Chair: of alcohol-free mouth rinses. Hemiparesis - Chair positioning Facial palsy/ dysphagia ; modified diet, oral Stroke survivors may need help with hygiene strategies. positioning due to paralysis/ weakness Caregiver assistance  REFERENCES Corliss, J. (2020). How to recognize a ministroke or stroke — and what to do. [online] Harvard Health. Available at: https://www.health.harvard.edu/blog/how-to-recognize-a- ministroke-or-stroke-and-what-to-do-2020111021318. (Accessed on 6th Nov, 2024) CLH Healthcare. (n.d.). 12 Facts About Strokes that Everyone Should Be Aware Of. [online] Available at: https://clhgroup.co.uk/learning-centre/lifestyle/12-facts-about- strokes-that-everyone-should-be-aware-of. (Accessed on 6th Nov, 2024) Dentalcare.com, 2024. Stroke - Management of Patients with Chronic Diseases. [online] Available at: https://www.dentalcare.com/en-us/professional-education/ce- courses/ce567 [Accessed 16 October 2024]. Dentalcare.com (2024) ‘Stroke - Management of patients with chronic diseases’. Dentalcare.com. Available at: https://www.dentalcare.com/en-us/professional- education/ce-courses/ce567 (Accessed: 16 October 2024). Dimensions of Dental Hygiene (2024) ‘Oral health and stroke’, Dimensions of Dental Hygiene. Available at: https://dimensionsofdentalhygiene.com (Accessed: 16 October 2024). Moawad, H., 2024. How Dental Problems Can Lead to Stroke. Verywell Health. [online] Available at: https://www.verywellhealth.com/dental-problems-can-lead-to-stroke- 4154717 [Accessed 16 October 2024]. National Heart, Lung and Blood Institute (2023). Stroke - What Is a Stroke? [online] www.nhlbi.nih.gov. Available at: https://www.nhlbi.nih.gov/health/stroke. (Accessed on 6th Nov, 2024) NHS (2022a). Symptoms - Stroke. [online] Available at: https://www.nhs.uk/conditions/stroke/symptoms/ (Accessed on 6th November 2024) NHS (2022b). Treatment - Stroke. [online] NHS. Available at: https://www.nhs.uk/conditions/stroke/treatment/ (Assessed on 6th November 2024) Pawlukowska, W., Zawiślak, A., Masztalewicz, M. and Grocholewicz, K., 2024. Oral Health in Patients Hospitalized Because of Ischemic Stroke. Journal of Clinical Medicine, 13(15), p.4556. Available at: https://www.mdpi.com/2077-0383/13/15/4556 [Accessed 16 October 2024]. Pawlukowska, W., Zawiślak, A., Masztalewicz, M. and Grocholewicz, K. (2024) ‘Oral Health in Patients Hospitalized Because of Ischemic Stroke’, Journal of Clinical Medicine, 13(15), p. 4556. Available at: https://www.mdpi.com/2077-0383/13/15/4556 (Accessed: 16 October 2024). Stroke Association (2024). Stroke Statistics. [online] www.stroke.org.uk. Available at: https://www.stroke.org.uk/stroke/statistics. (Accessed on 6th Nov, 2024) Verywell Health (2024) ‘How dental problems can lead to stroke’, Verywell Health. Available at: https://www.verywellhealth.com/dental-problems-can-lead-to-stroke- 4154717 (Accessed: 16 October 2024).