Stroke Flashcards
Stroke
Permeant damage to the brain
- Evidence of acute infarction
Transient Ischemic Attack
Symptoms last for less than 24 hours
- No imaging evidence of acute infarction
Hemmoraghic Stroke
Blood leaks into brain tissue
Ischemic Stroke
Blood supply is cut from areas of the brain
Stroke
- Symptoms
Face is drooping
Arms can not raise
Speech is slurred
Time to call 911
Five Cardinal Signs of Stroke
Severe Headache
Sudden Weakness
Sudden Changes in Speech
Sudden Changes in Vision
Sudden Dizziness
Primary Prevention
Hypertension
- <130/80
Dyslipidemia
- Statins
Diabetes
- GLP-1 / SGLT2i
Diet
Exercise
Smoking
Antiplatelets
Primary Prevention
- ASA
Aspirin is not recommended for primary prevention
Acute Stroke Management
- Stroke
- CT Scan
3a Ischemic –> Give tPA or Endovascular Intervention with/without tPA
3b. Hemorrhage –> Surgery
Clot Busters
tPA (Alteplase) or TNK (Tenecteplase)
When to give clot blusters
Administer within 4.5 hours of presentation of symptoms
When to do endovascular intervention
Can perform within 6 hours of onset of stroke
- Some patients can do 24 hours
Antithrombotics in stroke
TNK/TPA or EVT is more important than rapid administration of antiplatelet
- Antiplatelets used
- Anticoagulants are not used
No thrombolytics
- After ruling out hemorrhage stroke can give ASA
Gave thrombolytics
- Wait 24 hours + CT to rule out hemorrhagic transformation, then can start ASA
Dual Antiplatelets
Increased benefit in TIA/Minor Stroke
- 21-30 days only, then step down to single platelet
Hemorrhagic Transformation
Bleeding into ischemic/dead brain tissue
Secondary Stroke Prevention
Hypertension (Perindopril)
- 130/80
Dyslipidemia (Atorvastatin 80 mg)
- LDL <1.8
Diabetes (Lifestyle, Metformin, GLP-1, SGLT2i)
Smoking
