Category: Stroke

ICH Bleed after given TPA Get CBC, PT, aPTT, fibrogen level Type and match Cryoprecipitate 10 units over 30 minutes Tranexamic acide 1 gram over 10 minutes or Aminocaproic acid 4 gram over 1 hour...

Bleeding into the space outside the brain under the dura. Acute SDH – caused by tear of bridging veins, rarely from small cortical arterial bleed Chronic SDH: form a hydroma Acute on chronic SDH: from rebleed Risk factors Older age alcohol abuse previous traumatic brain injury more often in...

This review will discuss the nontraumatic subarachnoid hemorrhage, which consisted of about 3% of all acute stroke. Cause: Cerebral aneurysm For discussion of unruptured aneurysm, click here. Clinical Sudden onset severe headache Neck stiffness May occur during activity or rest Hunt & Hess Scale Grade 1 – Asymptomatic, or...

Anticoagulation recommended for atrial fibrillation, atrial flutter MI with mural thrombus Mechanical cardiac valve PFO with evidence of deep vein thrombosis Hypercoagulable state, warfarin is indicated for Antiphospholipid syndrome Inherited thrombophilia Anticoagulation can be considered Dilated cardiomyopathy, EF < 35% Restrictive cardiomyopathy Acute STEMI without mural thrombus but with...

24 hr Post TPA CT or MRI – no bleed Start aspirin 300 mg suppository of 325 mg daily po or Plavix 325 mg qd Start High intensity Statin, such as Atorvastatin 40-80 mg qd Continue on heart monitor, watch for atrial fibrillation Consider Echocardiogram Cardiogenic emboli suspected Keep...

Plan Get CTA head and neck if not done, Creat has to be normal. If large artery thrombosis, if Last known normal < 24 hours, consider intervention therapy. Give Aspirin po 325 mg or 300 mg suppository or other antiplatelet agent document reason for no tpa, such as past...

Stroke and Critical care risks NIH Stroke scale CHA2DS2VASc Stroke Risk Modified Rankin Scale ASPECTS – Alberta Stroke Program Early CT score Glasgow Coma Scale Seizure – anticonvulsant calculator Phenytoin Correction Cognitive evaluation RASS – Richmond agitation sedation scale MMSE – Mini Mental status exam MOCA – Montreal Cognitive...

Patent foramen ovale 25-30 percent of population has PFO based on autopsy and community based TEE study. Size of PFO increases with age Most patients are asymptomatic In cryptogenic stroke Cryptogenic stroke accounts for 20-40% of ischemic stroke Most of these are embolic Paradoxical embolism from PFO is one...

This page contains a series of videos for nurses to learn about acute stroke. Click on the expand icon on the right lower corner to view full screen. Part 1: Is it a stroke? BE-FAST review Part 2: TPA Mechanical Thrmobectomy Part 3: General Stroke care Final Exam: Click...

Useful printable PDF handout Useful education video for patient...