Ischaemic Stroke: Causes, Incidence, and Thrombolytic Therapy

This report provides insights into the causes and incidence of ischaemic stroke in Australia, highlighting the importance of thrombolytic therapy in treating the condition. It also discusses the availability of resources for stroke recovery.

Running head: ISCHAEMIC STROKE
Ischaemic stroke
Name of the Student
Name of the University
Author note

1ISCHAEMIC STROKE
INTRODUCTION
Ischaemic stroke is considered as condition where the blood is unable to reach heart
due to possible causes that leads to the condition of ischaemic stroke in Australia. Ischaemic
stroke occurs when the brain is unable to receive adequate amount of oxygenated blood due
to blood clot in the arteries. The arteries are blocked or narrowed down due to fatty or
cholesterol deposition known as atherosclerosis hence the brain cells are unable to produce
energy and ultimately stop working. Ischaemic stroke is considered as one of the leading
cause of demise in Australia. Approximately, 475,000 people were suffering from stroke in
Australia that is predicted to increase by the end of 2050 (Strokefoundation.org.au, 2019). In
this report, a detail insight is provided on the incidence of ischaemic stroke and the advantage
of thrombolytic therapy in treating the condition of stroke. Enableme is a resource that is used
by the patient to help in recovery by using the provided information, tools and videos that
will help the patient to stay strong and identify various means that will assist them in
recovering as soon as possible.
INCIDENCE OF ISCHAEMIC STROKE IN AUSTRALIA
Ischaemic stroke occurs when the blood vessel are unable to supply adequate
oxygenated blood to the brain due to blockage in the artery carrying blood to the brain. The
condition may either result in brain dying or impairment thus affecting the overall function of
the brain (Aihw.gov.au, 2019). Ischaemic stroke is considered as one of the leading cause of
death and hospitalization in Australia. According to the survey conducted by Australian
Bureau of statistics, approximately 394,000 people had suffered from the condition of stroke
affecting 195,000 females and 199,000 males. The prevalence rate of stroke in Australia has
been similar or constant from 2003 to 2015 (Aihw.gov.au, 2019). Ischaemic stroke was
considered as the third premier burden affecting people who are more than 85 years and

2ISCHAEMIC STROKE
above thus affecting 9.4% of women and 7.5% of men. In the year 2016, approximately 8,200
death were recorded due to stroke that was accounted for 5.2% of total demise occurring in
Australia. The rate of death in Australia due to ischaemic stroke has declined in between the
year 1980 to 2016, because of modifiable risk factor like tobacco consumption, physical
slothfulness, overweight, escalated blood pressure and obesity (Abs.gov.au, 2019).
CAUSES OF ISCHAEMIC STROKE
Ischaemic stroke is considered as the most prevalent category of stroke, which is
majorly caused due to fatty deposition termed as atherosclerosis. In older people, the arteries
gets narrowed down due to age but certain risk factors also accelerates the incidence of
ischaemic stroke. The risk factors are obesity, hypertension, smoking or consumption of
tobacco, inadequate physical activity, consumption of excess alcohol and a past family
history or condition of cardiac diseases (Arboix, 2015). Various medical conditions are also
considered as the risk factor leading to the onset of stroke such as chronic kidney disease,
diabetes and insulin resistance. Uneven heart beat or atrial fibrillation is also considered as
the cause of developing ischaemic stroke that includes pericarditis, high blood pressure,
mitral valve illness, coronary heart disease, hyperthyroidism, cardiomyopathy and excess
intake of alcohol and caffeine (Healthdirect.gov.au, 2019).
THROMBOLYTIC THERAPY
Thrombolytic therapy is one of the most widely used therapy for dissolving the clot
that leads to the condition of stroke (Li et al., 2015). The therapy involves use or
consumption of drugs that result in breaking the clot in the arteries and allowing the blood to
flow normally (Alper et al., 2015). Tissue Plasminogen Activator (tPA) is most widely used
thrombolytic drug also known as clot-buster, is a heart medicine provided to the patient in the
hospital that reduces the complexity of stroke (Stroke.org.uk, 2019). The drug is given to the

3ISCHAEMIC STROKE
patient with either any heart attack condition or ischaemic stroke. The drug can be
administered by using arterial catheter or through intravenous method and the drug should be
given to the patient within four hours of stroke onset. Thrombolytic drug dissolves the blood
clot present in the artery and prevent any further damage in heart muscle (Berkhemer et al.,
2015).
The major benefit of using thrombolytic therapy is that it is directly administered in
the blood of the patient by using catheter or through intravenous method thus helping the
patient to disrupt the clot as soon as possible. In case of intravenous administration, the drug
is injected into the patient body by using intravenous needle, which transports the drug
directly into the patient body and the action of drug is visible in a short span of time thus
protecting the patient from a severe heart attack or condition (Xian et al., 2016). Hence, the
benefit of giving intravenous thrombolytic drug is that it prevents the enduring injury of
cardiac attack, terminate the damage caused due to ischaemic stroke and release the blood
clot present in the patient’s blood vessels.
The major limitation of using thrombolytic therapy is that before administering the
drug the doctor has to identify the risk factor to be sure if the patient has the symptom of
stroke or not and then provide the drug to the patient. The time period considered best for
drug administration is within six hours of onset of complications as the drug is most active
within that time period (Gurav et al., 2015). If the time period of disease onset is increased it
will result in low patient outcome. The patient with peptic ulcer, hypertension, acute liver
disease and haemorrhagic stroke should not consume this thrombolytic drug as it may lead to
some major health complication like fever, hypotension, bleeding and allergic reaction. The
most common limitation of using thrombolytic therapy or clot-buster is that it can increase
the risk of bleeding like discharge of blood in urine, nosebleeds, gum bleeding and black
stool (Khandelwal, Yavagal & Sacco, 2016).

4ISCHAEMIC STROKE

5ISCHAEMIC STROKE
RESOURCE AVAILABLE
Enable me is a widely used platform created by Australian stroke community and is
managed and owned by the stroke foundation. It is an online resource or platform that allow
the sufferers to talk or communicate and get support from the health professionals who are
present. The sufferers can ask question or can clarify if they have any query regarding their
health condition that will assists them to set their effective recovery goal. The people who
have already suffered from stroke or the healthcare professional’s extent help to the people
who have recently developed the condition of ischaemic stroke (Healthdirect.gov.au, 2019).
It is a large community that allow patient to help each other and guide each other with best
possible recovery goal. Enable me provides the patient with fact sheets and videos that will
have information reading the impact of stroke on an individual and their daily activity of life.
They also provide a tool that will help the patient to set and guide their personal recovery
goals.
An effective community forum is provided by this resource that allows the patient or
sufferers to raise or ask question regarding their health issue and can discuss their concern on
the symptom or risk factor. The patient who have survived from the condition of ischaemic
stroke can share their experience and guide people suffering from stroke with few effective
steps that will help them to recover from stroke condition. The most attractive benefit of
using enable me is that it conveys together the stroke videos, information, conversation and
tools retrieved from the other carers and survivors of ischaemic stroke
(Strokefoundation.org.au, 2019). Enable me is considered as a self-directed rehabilitation
process where the patient is solely responsible for their recovery. This resource allows the
patient to increase their knowledge on the condition of ischaemic stroke relating to the causes
that lead to ischaemic stroke, risk factors and recovery plan that will help the patient to

6ISCHAEMIC STROKE
understand and modify their living style for fast recovery. This resource has both positive and
negative impact on the patient. The positive impact is that it allows the patient or sufferers to
gain a better understanding and knowledge of their health condition and accordingly make
their recovery plan that will assist them in fast recovery (Enable Me, 2019). The negative
impact is that few patient can lose their moral and belief of recovery during acute ischaemic
stroke condition as they can learn about the negative consequences of their health condition
and develop the symptom of depression.
CONCLUSION
From this report it can be concluded that ischaemic stroke is one of the most prevalent
health condition affecting the population of Australia by blocking the arteries that carry
oxygenated blood to the heart therefore resulting in heart attack or heart stroke. In this report,
a detail insight was provided on the causes and risk factors that result in the condition of
ischaemic stroke by highlighting the overall incidence of stroke among the population of
Australia. The advantage of using thrombolytic therapy was also highlighted that involves
use of thrombolytic or clot-buster drug, thus releasing the blood clot and initiating the supply
of blood to the brain. Enable me is an online resource available for the patient to gain
information and construct a recovery plan to overcome from the health condition of stroke.

7ISCHAEMIC STROKE
REFERENCES
Abs.gov.au. (2019). 3303.0 - Causes of Death, Australia, 2015. Retrieved from
https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2015~Main
%20Features~Stroke~10003
Aihw.gov.au. (2019). Stroke and its management in Australia: an update, Table of contents -
Australian Institute of Health and Welfare. Retrieved from
https://www.aihw.gov.au/reports/heart-stroke-vascular-disease/stroke-and-its-
management-in-australia-an-update/contents/table-of-contents
Aihw.gov.au. (2019). Stroke. Retrieved from https://www.aihw.gov.au/getmedia/56bb591f-
6c56-4397-b928-8de6872e2cdd/aihw-aus-221-chapter-3-7.pdf.aspx
Alper, B. S., Malone-Moses, M., McLellan, J. S., Prasad, K., & Manheimer, E. (2015).
Thrombolysis in acute ischaemic stroke: time for a rethink?. Bmj, 350, h1075. doi:
https://doi.org/10.1136/bmj.h1075
Arboix, A. (2015). Cardiovascular risk factors for acute stroke: Risk profiles in the different
subtypes of ischemic stroke. World Journal of Clinical Cases: WJCC, 3(5), 418.
doi: 10.12998/wjcc.v3.i5.418
Berkhemer, O. A., Fransen, P. S., Beumer, D., van den Berg, L. A., Lingsma, H. F., Yoo, A.
J., ... & van Walderveen, M. A. (2015). A randomized trial of intraarterial treatment
for acute ischemic stroke. New England Journal of Medicine, 372(1), 11-20. DOI:
10.1056/NEJMoa1411587
Xian, Y., Federspiel, J. J., Grau-Sepulveda, M., Hernandez, A. F., Schwamm, L. H.,
Bhatt, D. L., ... & Bettger, J. P. (2016). Risks and benefits associated with prestroke
antiplatelet therapy among patients with acute ischemic stroke treated with

8ISCHAEMIC STROKE
intravenous tissue plasminogen activator. JAMA neurology, 73(1), 50-59.
doi:10.1001/jamaneurol.2015.3106
Enable Me. (2019). About. Retrieved from https://enableme.org.au/About-enableme
Gurav, S. K., Zirpe, K. G., Wadia, R. S., Pathak, M. K., Deshmukh, A. M., Sonawane, R. V.,
& Goli, N. (2015). Problems and limitations in thrombolysis of acute stroke patients
at a tertiary care center. Indian journal of critical care medicine: peer-reviewed,
official publication of Indian Society of Critical Care Medicine, 19(5), 265.
doi: 10.4103/0972-5229.156468
Healthdirect.gov.au. (2019). Stroke Foundation. Retrieved from
https://www.healthdirect.gov.au/partners/stroke-foundation
Healthdirect.gov.au. (2019). What causes a stroke? Retrieved from
https://www.healthdirect.gov.au/what-causes-a-stroke
Khandelwal, P., Yavagal, D. R., & Sacco, R. L. (2016). Acute ischemic stroke intervention.
Journal of the American College of Cardiology, 67(22), 2631-2644. DOI:
10.1016/j.jacc.2016.03.555
Li, L., Yiin, G. S., Geraghty, O. C., Schulz, U. G., Kuker, W., Mehta, Z., ... & Study, O. V.
(2015). Incidence, outcome, risk factors, and long-term prognosis of cryptogenic
transient ischaemic attack and ischaemic stroke: a population-based study. The Lancet
Neurology, 14(9), 903-913. https://doi.org/10.1016/S1474-4422(15)00132-5
Stroke.org.uk. (2019). Treatments. Retrieved from https://www.stroke.org.uk/what-is-
stroke/diagnosis-to-discharge/treatment
Strokefoundation.org.au. (2019). enableme - self directed rehabilitation — Stroke Foundation
- Australia. Retrieved from https://strokefoundation.org.au/en/About-Stroke/Help-
after-stroke/enableme

9ISCHAEMIC STROKE
Strokefoundation.org.au. (2019). Facts and figures about stroke — Stroke Foundation -
Australia. Retrieved from https://strokefoundation.org.au/About-Stroke/Facts-and-
figures-about-stroke