Management of stroke Flashcards
Limitations of CT in stroke?
- Brain changes may not be visible for several hours
- CT is not sensitive for blood after about one week
What is a cardioembolic stroke?
Occlusion of the cerebral vessels with debris from a cardiac source
Which type of stroke is fibrin dependent, i.e. “red thrombus”
Cardioembolic
Which type of stroke is platelet dependent, i.e. a “white thrombus”
Atheroembolic
Investigations you should carry out after someone has had stroke?
- Full lipid profile
- Blood pressure
- Carotid scan
- ECG
- Consider: 24 ECG (or longer), echo cardiogram
ABC of medical stroke prevention
A- antithrombotic therapy (antiplatelet/anticoagulant)
B- blood pressure
C- cholesterol
D- diabetes, don’t smoke
Many people have problems swallowing etc following stroke, what could you consider?
NG tube
IMPORTANT ABCD2 FOR STROKE RISK
A - age (>60) =1
B - blood pressure =1
C - clinical features (unilateral weakness =2, speech disturbance without weakness =1, other =0)
D - duration of symptoms (>60 =2, 10-59 =1, /= 5 is very bad!!!
Thromboxane inhibitor
Aspirin
ADP-receptor antagonist
Clopidogrel
Prasugrel
Name 3 antiplatelets
- Aspirin
- Clopidogrel
- Dipyradimole
A REALLY important stroke study we should probably know about?
The PROGRESS study (the Perindopril PROtection aGainst REcurrent Stroke Study)
-showed that perindopril (4mg) + indapamide (2.5mg) was very good
Low cholesterol is associated with an increased risk of which type of stroke?
Haemorrhagic
but statins do still help to lower risk of stroke, depends on which type of stroke they had I think
Name the surgical procedure which helps to lower risk of recurrent stroke
(carotid) endarectomy
Why do small vessels in the brain become damaged?
- blood pressure
- blood sugar (diabetes)
