managment of TIa stroke

Question 1

what is the difference between a TIA and stroke ?

Answer 1

resolving of the symptoms before 24 hrs is TIA
persistence of symptoms after 24 hrs is a stroke

Question 2

what is the best first treatment for a stroke ?

Answer 2

non contrast head CT

Question 3

what piece of information does a head CT tell us ?

Answer 3

if its ischemic or hemorrhagic

Question 4

generally what are the treatment approaches for each type of stroke ?

Answer 4

if it is ischemic then thrombolysis should be considered
if it is hemorrhagic then thrombolysis is contraindicated
hawi 3al 3ayan then surgery

Question 5

what is the time period in which ateplase can be used and most benefited from ?

Answer 5

3 hour window benefit for alteplast tissue plasminogen activator

Question 6

what are the contraindications associated with alteplase ?

Answer 6

stroke or head trauma for the past 3 months
arterial puncture
internal bleeding or trauma
BP above 185
INR above 1.7
low platelets
elevated PTT
hypoglycemia
any history of intracranial bleeding

Question 7

what is the post stroke management ?

Answer 7

aspirin for prophylaxis
ECG - look for a fib

Question 8

if the patient is allergic to aspirin what should be used instead ?

Answer 8

clopidogrel

Question 9

what is the point of looking for a fib on ECG ?

Answer 9

a fib plus stroke calls for the use of warfarin or other anticoag

Question 10

what is the management before anf after 4 hours in ischemic stroke ?

Answer 10

before 4 hours give alteplase
after 4 hours give aspirin

Question 11

what is the management for hemorrhagic stroke ?

Answer 11

NO ALTEPLASE
reduce blood pressure rapidly
if the patient is on anticoagulant reverse it