20 cards Flashcards
Initial investigation of suspected ICP
CT head non contrast
What does the NIHSS stroke scale/ score used for>
Qualifies the severity of a stroke in the acute setting
- Increasing scores indicate a more severe stroke and has been shown to correlate w the size of the infarction on both CT and MRI evaluation
- If the score is assessed within the first 48 hours following a stroke correlate with clinical outcomes at the 3 mo and 1 year mark
- Patients with total score <4 have favourable outcomes and have a high likelihood of functional independence regardless of tx
What BP is a contraindication to thrombolysis
Uncontrolled HTN SBP >185/ >110
Indications for an immediate CT head
Suspected skull fractures/ depressed skull fracture
GCS<13 within 1 hour
GCS < 15 at hours post injury
Any sign of basal skull fracture - hemotympanum, panda eyes, CSF leakage, Battle sign
Post traumatic seizure
FND
more than 1 ep of vomiting
Epilepsy for generalized seizure for males
Sodium valproate
Epilepsy for focal seizure for males
Lamotrigine or levetiracetam
Fluctuating confusion and reduced consciousness
chronic subdural hematoma
Which primary tumors are the MCC of brain mets
Lung
Indications for CT head within 8 hours of the head injury
LOC or amnesia since the injury plus:
- age >65 yo
- hx of bleeding/ clotting disorders including anticoagulants
- dangerous mechanism of injury: pedestrian or cyclist struck by MVA, an occupant ejected from a MVA, fall from height >1m
- more than 30 min retrograde amnesia of events before head injury
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Dense MCA sign
Standard target time for thrombectomy in acute ischemic stroke
6 hours
