|
|
| Line 20: |
Line 20: |
| *[[Thrombocytopenia]] | | *[[Thrombocytopenia]] |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Monitor for infection | | *Monitor for [[infection]] |
| *Assess hematocrit and platelet count to identify hemorrhagic risk and complications | | *Assess [[hematocrit]] and [[platelet count]] to identify hemorrhagic risk and complications |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[Lipid profile|'''Lipid profile''']] | | | style="padding: 5px 5px; background: #F5F5F5;" |[[Basic metabolic panel|'''BMP''']]/[[Osmolarity|'''Osmolarity''']] |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Increased [[LDL]], [[triglycerides]] and [[cholesterol]] | | *Increased or decreased serum NA2+, K+, Ca2+ |
| | *Change in osmolarity |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *May increase the risk of thromboembolic event<ref name="pmid19901173">{{cite journal| author=Willey JZ, Xu Q, Boden-Albala B, Paik MC, Moon YP, Sacco RL et al.| title=Lipid profile components and risk of ischemic stroke: the Northern Manhattan Study (NOMAS). | journal=Arch Neurol | year= 2009 | volume= 66 | issue= 11 | pages= 1400-6 | pmid=19901173 | doi=10.1001/archneurol.2009.210 | pmc=2830863 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19901173 }} </ref><ref name="pmid24250834">{{cite journal| author=Togha M, Gheini MR, Ahmadi B, Khashaiar P, Razeghi S| title=Lipid profile in cerebrovascular accidents. | journal=Iran J Neurol | year= 2011 | volume= 10 | issue= 1-2 | pages= 1-4 | pmid=24250834 | doi= | pmc=3829214 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24250834 }} </ref><ref name="pmid24696996">{{cite journal| author=Lisak M, Demarin V, Trkanjec Z, Basić-Kes V| title=Hypertriglyceridemia as a possible independent risk factor for stroke. | journal=Acta Clin Croat | year= 2013 | volume= 52 | issue= 4 | pages= 458-63 | pmid=24696996 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24696996 }} </ref> | | *Monitor osmolarity for guidance of [[osmotic diuresis]] |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[PT|'''PT''']]'''/[[APTT]]/[[INR]]''' | | | style="padding: 5px 5px; background: #F5F5F5;" |[[PT|'''PT''']]'''/[[APTT]]/[[INR]]''' |
| Line 39: |
Line 40: |
| *Increased BUN and creatinine | | *Increased BUN and creatinine |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Mild to moderate renal dysfunction is an independant risk factor for ischemic stroke<ref name="pmid16864812">{{cite journal| author=Koren-Morag N, Goldbourt U, Tanne D| title=Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease. | journal=Neurology | year= 2006 | volume= 67 | issue= 2 | pages= 224-8 | pmid=16864812 | doi=10.1212/01.wnl.0000229099.62706.a3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16864812 }} </ref><ref name="pmid25526464">{{cite journal| author=Hao Z, Yang C, Liu M, Wu B| title=Renal dysfunction and thrombolytic therapy in patients with acute ischemic stroke: a systematic review and meta-analysis. | journal=Medicine (Baltimore) | year= 2014 | volume= 93 | issue= 28 | pages= e286 | pmid=25526464 | doi=10.1097/MD.0000000000000286 | pmc=4603096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25526464 }} </ref> | | * |
| *May be associated with poor prognosis in patients with ischemic stroke<ref name="pmid25526464">{{cite journal| author=Hao Z, Yang C, Liu M, Wu B| title=Renal dysfunction and thrombolytic therapy in patients with acute ischemic stroke: a systematic review and meta-analysis. | journal=Medicine (Baltimore) | year= 2014 | volume= 93 | issue= 28 | pages= e286 | pmid=25526464 | doi=10.1097/MD.0000000000000286 | pmc=4603096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25526464 }} </ref><ref name="pmid25091540">{{cite journal| author=Laible M, Horstmann S, Rizos T, Rauch G, Zorn M, Veltkamp R| title=Prevalence of renal dysfunction in ischaemic stroke and transient ischaemic attack patients with or without atrial fibrillation. | journal=Eur J Neurol | year= 2015 | volume= 22 | issue= 1 | pages= 64-9, e4-5 | pmid=25091540 | doi=10.1111/ene.12528 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25091540 }} </ref> | | *May be associated with poor prognosis in patients with intracerebral hemorrhage and hematoma expansion |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |'''Serum [[Homocysteine|homocysteine]] level''' | | | style="padding: 5px 5px; background: #F5F5F5;" |[[Toxicology screen|'''Toxicology screen''']]'''/Serum alcohol level''' |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Increased levels of serum homocysteine levels | | *Increased levels of serum |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *May be associated with increased risk of thromboembolic event<ref name="pmid27629768">{{cite journal| author=Yao ES, Tang Y, Xie MJ, Wang MH, Wang H, Luo X| title=Elevated Homocysteine Level Related to Poor Outcome After Thrombolysis in Acute Ischemic Stroke. | journal=Med Sci Monit | year= 2016 | volume= 22 | issue= | pages= 3268-73 | pmid=27629768 | doi= | pmc=5034885 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27629768 }} </ref><ref name="pmid24174694">{{cite journal| author=Ashjazadeh N, Fathi M, Shariat A| title=Evaluation of Homocysteine Level as a Risk Factor among Patients with Ischemic Stroke and Its Subtypes. | journal=Iran J Med Sci | year= 2013 | volume= 38 | issue= 3 | pages= 233-9 | pmid=24174694 | doi= | pmc=3808947 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24174694 }} </ref> | | *Identify illicit drug use or excessive alcohol |
| | *Identify exogenous toxins that can cause [[intracerebral hemorrhage]] (ICH) |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[Basic metabolic panel|'''Basic metabolic panel''']]
| |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Increased or decreased serum NA2+, K+, Ca2+
| |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *May mimic or complicate patients with ischemic stroke<ref name="pmid23134903">{{cite journal| author=Alam MN, Uddin MJ, Rahman KM, Ahmed S, Akhter M, Nahar N et al.| title=Electrolyte changes in stroke. | journal=Mymensingh Med J | year= 2012 | volume= 21 | issue= 4 | pages= 594-9 | pmid=23134903 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23134903 }} </ref><ref name="pmid21510233">{{cite journal| author=Guven H, Cilliler AE, Koker C, Sarikaya SA, Comoglu SS| title=Association of serum calcium levels with clinical severity of acute ischemic stroke. | journal=Acta Neurol Belg | year= 2011 | volume= 111 | issue= 1 | pages= 45-9 | pmid=21510233 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21510233 }} </ref><ref name="pmid23966823">{{cite journal| author=Farahmand F, Choobi Anzali B, Heshmat R, Ghafouri HB, Hamedanchi S| title=Serum Sodium and Potassium Levels in Cerebro-vascular Accident Patients. | journal=Malays J Med Sci | year= 2013 | volume= 20 | issue= 3 | pages= 39-43 | pmid=23966823 | doi= | pmc=3743980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23966823 }} </ref> | | * |
| | | style="padding: 5px 5px; background: #F5F5F5;" | |
| | * |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[HbA1C|'''HbA1C''']] | | | style="padding: 5px 5px; background: #F5F5F5;" |[[HbA1C|'''HbA1C''']] |
| Line 58: |
Line 60: |
| *Increased levels of HbA1c | | *Increased levels of HbA1c |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *May suggest control of diabetes in past few months | | * |
| *Increased levels associated with increased risk of ischemic stroke<ref name="pmid22111048">{{cite journal| author=Oh HG, Rhee EJ, Kim TW, Lee KB, Park JH, Yang KI et al.| title=Higher glycated hemoglobin level is associated with increased risk for ischemic stroke in non-diabetic korean male adults. | journal=Diabetes Metab J | year= 2011 | volume= 35 | issue= 5 | pages= 551-7 | pmid=22111048 | doi=10.4093/dmj.2011.35.5.551 | pmc=3221032 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22111048 }} </ref>
| |
| *May be associated with poor prognosis in patients with ischemic stroke
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |'''Blood glucose levels''' | | | style="padding: 5px 5px; background: #F5F5F5;" |'''Blood glucose levels'''<ref name="pmid9249937">{{cite journal| author=Sawyer GJ, Fabre JW| title=Indirect T-cell allorecognition and the mechanisms of immunosuppression by allogeneic blood transfusions. | journal=Transpl Int | year= 1997 | volume= 10 | issue= 4 | pages= 276-83 | pmid=9249937 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9249937 }}</ref> |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Increased or decreased levels of blood glucose | | *Increased or decreased levels of blood glucose |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *[[Hyperglycemia]] is associated with poor prognosis of ischemic stroke<ref name="pmid11493160">{{cite journal| author=Kagansky N, Levy S, Knobler H| title=The role of hyperglycemia in acute stroke. | journal=Arch Neurol | year= 2001 | volume= 58 | issue= 8 | pages= 1209-12 | pmid=11493160 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11493160 }} </ref><ref name="pmid20848328">{{cite journal| author=Bruno A, Liebeskind D, Hao Q, Raychev R, UCLA Stroke Investigators| title=Diabetes mellitus, acute hyperglycemia, and ischemic stroke. | journal=Curr Treat Options Neurol | year= 2010 | volume= 12 | issue= 6 | pages= 492-503 | pmid=20848328 | doi=10.1007/s11940-010-0093-6 | pmc=2943579 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20848328 }} </ref><ref name="pmid21861124">{{cite journal| author=Baker L, Juneja R, Bruno A| title=Management of hyperglycemia in acute ischemic stroke. | journal=Curr Treat Options Neurol | year= 2011 | volume= 13 | issue= 6 | pages= 616-28 | pmid=21861124 | doi=10.1007/s11940-011-0143-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21861124 }} </ref><ref name="pmid17099262">{{cite journal| author=Gilmore RM, Stead LG| title=The role of hyperglycemia in acute ischemic stroke. | journal=Neurocrit Care | year= 2006 | volume= 5 | issue= 2 | pages= 153-8 | pmid=17099262 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17099262 }} </ref> | | *May be associated with poor prognosis in patients with [[Intracerebral hemorrhage]] |
| *Hypoglycemia may complicate or mimic patients with ischemic stroke<ref name="pmid21211743">{{cite journal| author=Radermecker RP, Scheen AJ| title=Management of blood glucose in patients with stroke. | journal=Diabetes Metab | year= 2010 | volume= 36 Suppl 3 | issue= | pages= S94-9 | pmid=21211743 | doi=10.1016/S1262-3636(10)70474-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21211743 }} </ref>
| |
| |- | | |- |
| | style="padding: 5px 5px; background: #F5F5F5;" |[[Cardiac enzymes|'''Cardiac enzymes''']] | | | style="padding: 5px 5px; background: #F5F5F5;" |[[Cardiac enzymes|'''Cardiac enzymes''']] |
| Line 81: |
Line 80: |
| *Serum and urine B-HCG | | *Serum and urine B-HCG |
| | style="padding: 5px 5px; background: #F5F5F5;" | | | | style="padding: 5px 5px; background: #F5F5F5;" | |
| *Rule out pregnancy in all female patients with ischemic stroke since t-PA is a class C agent<ref name="pmid23632643">{{cite journal| author=Grear KE, Bushnell CD| title=Stroke and pregnancy: clinical presentation, evaluation, treatment, and epidemiology. | journal=Clin Obstet Gynecol | year= 2013 | volume= 56 | issue= 2 | pages= 350-9 | pmid=23632643 | doi=10.1097/GRF.0b013e31828f25fa | pmc=3671374 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23632643 }} </ref> | | *Rule out pregnancy in all female patients with hemorrhagic stroke |
| |- | | |- |
| |} | | |} |