Ischemic Stroke Diagnosis and Management

Question 1

First task in evaluating a presumptive stroke pt

Answer 1

stabilize all vital signs

Question 2

Diagnotic work up for stroke pt?

Answer 2

• EKG with rhythm strip
• Chest x-ray to evaluate heart size
• CBC with differential and platelett count
• Chemistry profile (glucose, BUN, electrolytes)
• Lipid profile
  cliotting times
  Head CT without contrast

Question 3

Head CT scans begin to detect infarcts stemming from ischemic stroke in what time frame

Answer 3

6-12 hours…Thus, the head CT is highly sensitive to hemmorhage and thus is indicated in all patients presenting with stroke symptoms to rule out hemorrhagic stroke.

Question 4

What type of radiological study is very sensitive to early ischemic changes due to stroke….KNOW!!!

Answer 4

MRI Diffusion Weighted Images (MRI DWI) to detect early ischemic change

Question 5

Acute treatment of stroke: Less than 4.5 hr from syptom onset?

Answer 5

• Treat with IV tPA
• IF less than 6 hours from symptom onset treat with intraARTERIAL tPA.
• If less than 8 hours from symptom onset retrieve clot