Ischemic stroke early assessment
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Early recognition of the signs of stroke is generally regarded as important. Only detailed physical examination and medical imaging provide information on the presence, type, and extent of stroke, and hence hospital attendance — even if the symptoms were brief — is advised.
Studies show that patients treated in hospitals with a dedicated Stroke Team or Stroke Unit and a specialized care program for stroke patients have improved odds of recovery.
Early assessment
The initial assesment goals of ischemic stroke may include the following. [1]
| 1) Airway 2) Breathing | 1) O2 administration at SpO2<94%
2) Ventilatory assisstance is provided to patients who have difficulty breathting 3) IV fluids or vasopressors are given to maintain hemodynamic stability | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Early Diagnosis | History and PE
1) Help assess the severity of neurological deficit | Initial diagnostic tests
1) Noncontrast brain CT or brain MRI | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Early assessment of ischemic stroke | Reperfusion therapy | Medical r-tPA in eligible patients within 3-4.5 hours of onset of symptoms | Surgical | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Symptomatic relief | 1) Fever 2) Headache 3) Shortness of breath | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Prognosis | 1)NIHSS scoring 2)Glassgow coma scale | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Jauch EC, Saver JL, Adams HP, Bruno A, Connors JJ, Demaerschalk BM; et al. (2013). "Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association". Stroke. 44 (3): 870–947. doi:10.1161/STR.0b013e318284056a. PMID 23370205.