STROKE-ACUTE MANAGEMENT

SUMMARY

1. ABCs of Resuscitation: ensure airway, breathing, circulation; commence Aspirin & Clopidogrel within 24 hours; maintain adequate perfusion pressure; BSL < 10, manage fever, assess swallowing.

2. Intravenous Fibrinolytics (tPA): for select patients who present ≤ 4.5 hours.

3. Endovascular Clot Retrieval (ECR): for select patients who present ≤ 6-24 hours (thrombotic, involving major vessels).
4. Intra-arterial Thrombolytic Therapy: for select patients who present ≤ 6 hours, who have contraindications to or have not responded to IV fibrinolytic therapy.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].