Term
| Management of acute stroke patient w/o compelling indications |
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Definition
1. Brain CT - r/o hemorrhage
2. Carotid US
3. TTE for patent foramen ovale
4. Monitor BP <220/120
5. Monitor for Fever, hypoglycemia, swallow study, PT/OT eveal & neuro exam, depression
6. early mobilization |
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Term
| what is the preferred treatment of ischemic stroke < 3 hours of stroke onset? |
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Definition
thrombolytics (tPA) when BP < 185/110 and hold ASA for 24hours to prevent bleeding
If BP > 185/110 give iv labetolol or nicardipine |
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Term
| what is the preferred treatment of ischemic stroke > 3 hours of stroke onset? |
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Definition
1st line ASA
2nd line clopidogrel (plavix)
No Heparin! |
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Term
| In a stroke patient, w/ BP < 220/120, CT negative for hemorrhage and normal EKG, what is the best management of BP? |
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Definition
| Just monitor the patient's BP and ensure it doesn't drop too fast. |
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Term
| How do you evaluate a patient who presents with thunderclap HA severe and explosive w max intensity about 60s of onset (sub-arachnoid hemorrhage)? |
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Definition
1. CT if you suspect subarachnoid hemorrhage (usu from ruptured intracranial aneurysm)
2. If CT is negative, do an LP looking for xanthochromia or gross hemorrhage which is diagnostic for subarachnoid hemorrhage
3. repeat CT or MRI angiogram to confirm
4. Treat with surgical clipping w/n 72h or metallic coils to obliterate the aneurysm. |
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