00:00
So here are our goals
for stroke prevention.
00:03
If someone has a TIA,
we want to address the underlying cause.
00:08
Your patient presented the ER
with all these symptoms
We've run these tests
so we could figure out
what's the underlying cause of the TIA.
00:16
For some people, it's an early sign
of more trouble to come.
00:19
So if we can treat that cause,
we might be able to prevent
or at least minimize the effect
of a future stroke.
00:25
So it might be caused
from a carotid occlusion,
artery stenosis,
a cardiogenic embolism,
an intracranial larger
artery atherosclerosis,
any one of those things
could be a cause.
00:37
Now, here's what I'd like you to do:
pause the video,
take a look at each one of those items
listed under the underlying cause of TIA,
look back through the tests
that we just talked about,
see which tests
would identify or rule out
one of these diagnoses
we have listed there.
00:56
That'll help you make it
rock solid in your mind
the use of each of these exams.
01:02
Okay. Welcome back.
01:04
I hope you took
the opportunity to do that
because it will help to really lay that
groundwork down in your own brains.
01:09
The next one is lifestyle modification.
01:12
Just like anything else we talk about,
healthy diet,
increased activity and exercise,
and stopping smoking
if the patient is,
are really important to preventing
stroke and heart disease.
01:25
So these are tough ones.
01:26
Don't just brush over these.
01:28
Spend some time
talking to your patients
and help them identify
the next step they can take.
01:34
Someone is not going to go from smoking
you know, two packs of cigarettes a day,
to not smoking at all.
01:40
So work with your patient,
be patient with them,
use the concepts
of motivational interviewing,
and help them
just to identify the next step
toward better health
in those areas.
01:52
We've also got medications
that will likely be considered
because we're going to want
to monitor and control blood pressure.
01:57
Absolutely.
01:58
So we'll probably look
at some antihypertensives
with the healthcare provider.
02:02
Now there's a wide range
of antihypertensives that can be effective.
02:07
So it depends on what's going on
with a patient,
what their lifestyle is like,
or the risk factors they have.
02:13
The healthcare provider will work
with the patient and with you
to help decide what would be
the best option for this patient.
02:19
They'll also consider statins.
02:22
These will lower--
These are cholesterol-lowering drugs.
02:25
If we can lower cholesterol,
we're going to lower the risk
of that atherosclerosis,
that stenosis are hardening
and narrowing of the arteries.
02:33
And lastly, they're going to think
about antiplatelets.
02:36
Remember, platelet's job
is to clump together, right?
To adhere to and to aggregate,
to clump that platelet party.
02:43
And anytime you have a platelet party,
you've got a clot,
and that clot is a risk to break off
and travel through to parts
where you don't want it to go.
02:52
In this case, we're talking
about in the brain.
02:55
So if we're looking
at medication options,
we're gonna look at antihypertensives,
statins, and antiplatelets.