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    Stroke (Ischemic)

    Stroke, CVA, TIA, Thromboembolic

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    Assessment & Plan (short)

    #Ischemic Stroke
    Patient with focal neuro deficits characterized by ***. Last seen normal at ***. On imaging noted to have ***. Contraindications to TPA reviewed, with decision to ***.
    Dx
    - NIHSS score ***
    - Stat NCHCT/CTA, Neuro consult
    - Glucose FS, INR, CBC, Cholesterol, A1c
    - EKG, Tele, consider TTE with bubble if <60 y.o
    Tx
    - If TPA given, ICU admission, Q1hr neuro checks x 24 until repeat NCHCT.  BP goal <185/110 (Nicardipine preferred).
    - If TPA not given, BP goal <220/120
    - Antiplatelet agent

    Assessment & Plan (long)

    #Ischemic Stroke
    Patient with focal neuro deficits characterized by ***. Last seen normal at ***. On imaging noted to have ***. Contraindications to TPA reviewed, with decision to ***. If given TPA, symptomatic ICH occurs in ~6% with 50% mortality. If large vessel occlusion in anterior circulation and <16h or even <24h LSN, consider mechanical thrombectomy. If cardioembolic etiology, give antiplatelet, with transition to AC in 4d to 2 weeks.
    Dx
    - NIHSS score ***
    - Stat NCHCT/CTA, Neuro consult
    - Glucose FS, INR, CBC, Cholesterol, A1c
    - EKG, Tele, consider TTE with bubble if <60 y.o
    Tx
    - If TPA given, ICU admission, Q1hr neuro checks x 24 until repeat NCHCT.  BP goal <185/110 (Nicardipine preferred).
    - If TPA not given, BP goal <220/120
    - Antiplatelet agent

    Organ systems
    • Neurological
    Medical field
    • Internal medicine
    Author
    Eric Lee
    Page info

    Originally created: July 5, 2020 by Eric Lee

    [xyz-ips snippet="lastupdated"] [xyz-ips snippet="sectioneditor"] [post-views]

    Number of revisions: [xyz-ips snippet="numrevisions"]

    References
    [xyz-ips snippet="easyfootnote"]
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