Stroke resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2] Ayokunle Olubaniyi, M.B,B.S [3]
Overview
The term 'stroke' is used to describe pathological conditions caused by brain ischemia or hemorrhage. According to the American Heart Association/American Stroke Association (July, 2013),[1] it is defined as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS) by a vascular cause, including cerebral infarction, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Therefore, by definition, trauma has to be ruled out before stroke can be diagnosed in a patient with a focal neurological deficit.
Management
Initial Evaluation
| Check vitals Stabilize ABC Brief Hx Rapid physical exam - neuro exam, NIHSS Activate stroke team Stat fingerstick Basic labs, troponin, EKG NPO Obtain stroke protocol | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Non-Contrast Enhanced CT (or MRI) to r/o hemorrhage | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Bleed Negative | Bleed Positive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acute Ischemic Stroke | Hemorrhagic Stroke | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Intracerebral Hemorrhage | Subarachnoid Hemorrhage | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Sacco, RL.; Kasner, SE.; Broderick, JP.; Caplan, LR.; Connors, JJ.; Culebras, A.; Elkind, MS.; George, MG.; Hamdan, AD. (2013). "An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association". Stroke. 44 (7): 2064–89. doi:10.1161/STR.0b013e318296aeca. PMID 23652265. Unknown parameter
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