Stroke/TIA Investigation and Management

Question 1

What are the basic set of investigations you would do for Stroke/TIA?

Answer 1

FBC/ESR

BP, ECG, CXR

Cerebral imaging - CT +/- MRI

Lipids, Glucose

Question 2

What are the more specific tests you might do for Stroke/TIA?

Answer 2

USS carotids

MRA/CTA

MRV/CTV

Catheter angiogram

Imaging of heart/great vessels: ECHO

Question 3

What is used for thrombolysis? And what time limit should it be used within?

Answer 3

IV rTPA = recombinant tissue plasminogen activator

<3 hours

No factors to increase the risk of ICH (high BP etc.)

Question 4

What is the difference between dysarthria and dysphasia?

Answer 4

Dysarthria - motor speech disorder

Dysphasia - disorder of language

Question 5

What antiplatelet drugs are used for Stroke/TIA?

Answer 5

ASA (aspirin) + dypyridamole + clopidogrel

ASA = Acetyl Salicylic Acid

Question 6

What anticoagulants are used for Stroke/TIA? And when is it appropriate?

Answer 6

Warfarin

C/E Stroke + CVST

Question 7

What types of vascular surgery are available for stoke?

Answer 7

Carotid endarterectomy

Stenting possible