management of stroke

Question 1

acute stroke management

Answer 1

CT/MRI
Thrombolysis-drugs/thrombectomy- mechanical
blood pressure lowering
DVT prevention

Question 2

how do you know if large vessel occlusion

Answer 2

CT/MRI angiogram

Question 3

thrombolysis

Answer 3

Lysis (Breakup) of clot by tissue plasminogen activator (usually alteplase)
Aim to restore flow and save penumbra
Licensed for use up to 4.5 hrs after onset of symptoms- after 4.5h risk bleeding too much making it worse

breaks up a clot by drug- alteplase

Question 4

when to not thrombolyse

Answer 4

previous haemorrage/stroke
blood pressue above 185/110
anticoagulant- warfarin INR >1.7, usage of DOAC in 24-48h
liver disease- GI bleeding
malignancy

Question 5

complications of thrombolysis

Answer 5

Haemorrhage- intra/extra cranial

anaphylaxis/angioedema

Question 6

when do most intracerebral haemorrages happen

Answer 6

first 3-6h

Question 7

types of thrombectomy

Answer 7

stent/aspiration

Question 8

risk of haemorrage after thrombolysis/thrombectomy

Answer 8

1/25 in first 7 days