Transcript Dr. Evelyn Chan ACUTE ISCHAEMIC STROKE What is stroke? What is a TIA?

Dr. Evelyn Chan
ACUTE ISCHAEMIC STROKE
What is stroke?
What is a TIA?
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What kind of stroke is it?
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Can you tell which part of the brain is damaged?
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Clinical examination
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Different types of stroke
Different kinds of stroke:
TACI, Total anterior circulation infarct
PACI, Partial anterior circulation infarct
LACI, Lacunar infarct
POCI, Posterior circulation infarct
The Oxford Community Stroke Project classification , OCSP
TACI
TOTAL ANTERIOR CIRCULATION INFARCT
What 3 components are present?
PACI
PARTIAL ANTERIOR CIRCULATION INFARCT
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Define PACI
LACI
LACUNAR ANTERIOR CIRCULATION INFARCT
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Give the clinical syndromes of a LACI.
POCI
POSTERIOR CIRCULATION INFARCT
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What symptoms are classified under POCI?
What are the causes of ischaemic stroke?
SWALLOWING TEST
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What is a swallowing test?
INVESTIGATIONS
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1. What investigations to confirm the diagnosis?
2. What investigations to determine the stroke mechanism?
3. How to risk stratify and prognosticate?
4. How to identify potentially treatable large obstructive lesions
of the cerebrovascular circulation?
MANAGEMENT: GENERAL MEASURES
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Oxygen and Airway Support
Adequate tissue oxygenation is imperative to prevent hypoxia
and potential worsening of the neurological injury
Observation
Vital signs and GCS
What is GCS?
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Mobilisation
How and when to mobilise the patient?
ANTIPLATELET AGENTS
Which antiplatelets to use?
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How to treat recurrent ischaemic strokes?
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How to treat cardioembolic strokes?
LIPID LOWERING THERAPY
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Statins
HYPERTENSION
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How to manage hypertension in acute stroke?
What are the causes of high BP in an acute stroke?
HYPERGLYCAEMIA
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How and when do you treat hyperglycaemia?
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Why treat?
RAISED INTRACRANIAL PRESSURE:
 How
to manage?
Thank you