Lecture on FAST-VAN Stroke Screening Assessment Tool

Introduction

• Presenters: Ruth Whalen & Sanchea Wazalu
• Purpose: Discuss the FAST-VAN Stroke Screening Assessment Tool for large vessel occlusion strokes.

Importance of Stroke

• Statistics:
  • 3rd leading cause of death in Canada
  • 20-30% of stroke patients die within 30 days
  • 40% die within a year
• Impact:
  • Leading cause of disability
  • Occurs every 9 minutes
  • High economic cost (medical bills, lost wages, decreased productivity)

Types of Stroke

1. Ischemic Stroke: Focus of FAST-VAN tool
   • Caused by thrombus in large vessels
   • Can travel from other body areas
2. Hemorrhagic Stroke:
   • Intercerebral hemorrhage
   • Aneurysmal subarachnoid hemorrhage
3. Transient Ischemic Attack (TIA):
   • Symptoms fluctuate/transient
   • Last minutes to an hour

Pathophysiology of Stroke

• Core Infarct: Dies immediately due to lack of blood flow
• Penumbra: Area around core that can be saved with timely treatment

Diagnostic Investigations

• CT of the Head:
  • Identifies acute ischemic changes (dark areas)
  • Hemorrhagic stroke effects over time
• CT Angiogram:
  • Looks at blood vessels for clots

Stroke Treatment

• Time is Brain: Faster treatment saves more brain tissue
• Standard Treatment (Past 20 Years):
  • TPA (tissue plasminogen activator)
  • Given within 4.5 hours of symptom onset
  • Strict criteria limit candidates
• New Therapy:
  • Endovascular Therapy:
    • Minimally invasive, performed by neurosurgeons/neurointerventional radiologists
    • Access via femoral artery to brain
    • Clot removal with suction/mechanical device
    • Can be combined with or without TPA

Candidates for Endovascular Therapy

• Confirmed large vessel occlusion
• Small infarct area
• Lasting normal under 12 hours

Stroke Centers in Saskatchewan

• Primary Stroke Centers:
  • Offer CT scans and neurovascular imaging
• Tertiary Stroke Center:
  • Offers endovascular therapy
  • Located at Royal University Hospital, Saskatoon

Introduction of FAST-VAN Screen

• Purpose: Identify patients with large vessel occlusion quickly
• FAST Assessment:
  • Facial drooping
  • Arm weakness
  • Speech problems
• VAN Assessment:
  • Vision: Gaze deviation
  • Aphasia: Loss of speech fluency/comprehension
  • Neglect: Ignoring one side of the body

FAST-VAN Screening Process

1. FAST Positive: Indicates potential stroke
2. VAN Positive: Confirmed large vessel occlusion
   • Vision, Aphasia, or Neglect positivity suggests endovascular therapy is required

Conclusion

• Implementation: FAST-VAN screening tool to expedite treatment
• Contact: Provided for further questions

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Note: "FASFAN" may be a typographical error and could be "FAST-VAN".