02-01-2015, 07:01 PM
hmmm thank u happy_studying
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Daily q1 - happy_studying
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02-01-2015, 07:04 PM
Yes hemorrhagic stroke management is conservative!!
Anticonvulsants - To prevent seizure recurrence Antihypertensive agents - To reduce BP and other risk factors of heart disease Osmotic diuretics - To decrease intracranial pressure in the subarachnoid space Intubation and hyperventilate if ICP increased and watch vitals and neuro check regularly .. So all conservative mx!!
02-01-2015, 08:22 PM
To summarize stroke management:
Any sudden onset neurological deficit 1st step do ct scan head (r/o hemorrhage) If blood present conservative management for hemorrhagic stroke: Anticonvulsants - To prevent seizure recurrence Antihypertensive agents - To reduce BP and other risk factors of heart disease Osmotic diuretics - To decrease intracranial pressure in the subarachnoid space Intubation and hyperventilate if ICP increased and watch vitals and neuro check regularly .. So for hemorrhagic stroke all conservative mx!! If no blood in CT or CT negative for stroke but dense hemiplegia do MRI brain ( stroke seen in MRI within 24 hrs-- most accurate test for stroke) So If ischemic stroke mx in the line of ischemic stroke has to be done As follows: If patient presents less than 3 hrs Give tpa unless contraindicated. If patient presents more than 3 hrs Give aspirin.. If patient is already on aspirin add dipyridamole to prevent recurrent stroke or the patient may be switched to clopidogrel!! Use heparin if patient has atrial fibrillation,basilar artery thrombosis or stroke in evolution Do EKG: if chronic afib:: continue on warfarin Do echo: if MS-- valvulotomy Do carotid duplex to look for stenosis If carotid stenosis more than 70 % -- do endarterectomy!! That's all i know about stroke management!! Feel free to add if u know more Thanks
02-01-2015, 08:31 PM
Also contraindications for tpa::
1.hemorrhagic stroke or h/o intracranial hemorrhage 2.stroke or serious head trauma within 3 months 3.hemorrhage (GI/GU) within 21 days 4.surgery within 14 days 5.arterial puncture within 7 days 6. Lumbar puncture within 7 days P.s.About post bp mx following tpa we have already discussed in the previous page and the question given above!! |
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