17. Stroke Management in the ER *gave questions

Question 1

Are wakeup strokes treated with tPA? Why or why not?

Answer 1

You need to know exactly what time symptoms began (ie the pts “last known normal”); if the pt wakes up with symptoms, there is no way of knowing this; therefore currently, wakeup stokes are not treated with tPA

Question 2

What does stroke mimic?

Answer 2

Stroke mimics include complex migraine, seizure & hypoglycemia (remember to check blood sugar levels)

Question 3

What is the definition of a stroke?

Answer 3

An episode of neurological dysfunction caused by focal infarction of the brain, spinal cord, retina, in which the Central Nervous System infarction was defined by pathology, imaging** or other objective evidence of ischemia in a defined vascular distribution, or by symptoms that persisted greater than 24 hours, or until death, with other non-stroke causes excluded.