Acute stroke care a manual from the University of Texas-Houston Stroke Team
You have just encountered a possible stroke patient. You ask yourself, what should I do first? How do I know it is a stroke? Is it too late to reverse the damage? How do I do the right things in the right order? This book will help you answer these critical questions. It provides practical advice on...
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| Format: | Elektronisch E-Book |
| Sprache: | English |
| Veröffentlicht: |
Cambridge
Cambridge University Press
2007
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| Schriftenreihe: | Pocket clinician
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| Online-Zugang: | BSB01 FHN01 URL des Erstveröffentlichers |
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Inhaltsangabe:
- Preface List of abbreviations 1 Stroke in the emergency department Is this a stroke? What type of stroke? 2 What to do first Airway eathing What was the time of onset? How bad are the symptoms now? Do a non-contrast head CT If the CT shows no blood, try to get the artery open Recommended diagnostic evaluation 3 Ischemic stroke Definition Etiology Diagnosis The four components of ischemic stroke care Acute therapy and optimization of neurological status Etiological work-up for secondary prevention Prevention of neurological deterioration or medical complications Stroke recovery and rehabilitation Ischemic stroke outcome General timeline 4 TPA protocol TPA indications Strong contraindications Relative contraindications Procedure Dose Sample post-TPA orders Risks vs. benefits of TPA Unproven therapies 9 Subarachnoid hemorrhage (SAH) Definition Epidemiology Presentation Diagnosis Ruptured aneurysms : management Prognosis Admission sequence Unruptured aneurysms 10 Organization of stroke care Timely care Stroke units Stroke centers Stroke teams 11 Rehabilitation Secondary stroke prevention Prevention of medical complications Multidisciplinary rehabilitation team Discharge planning Appendix 1 : Numbers and calculations Appendix 2 : IV TPA dosing chart Appendix 3 : Sample admission orders Appendix 4 : Sample discharge summary Appendix 5 : Stroke radiology
- Appendix 6 : Transcranial doppler ultrasound (TCD) Appendix 7 : Heparin protocol Appendix 8 : Insulin protocol Appendix 9 : Medical complications Appendix 10 : Brainstem syndromes Appendix 11 : Cerebral arterial anatomy Appendix 12 : Stroke in the young and less common stroke diagnoses Appendix 13 : Brain death criteria Appendix 14 : Neurological scales Recommended reading References 5 Neurological deterioration in acute ischemic stroke Probable causes Initial evaluation of patients with neurologic deterioration Stroke enlargement Drop in perfusion pressure Recurrent stroke Cerebral edema and mass effect Hemorrhagic transformation Metabolic disturbance Seizure Symptom fluctuations without a good cause The uncooperative patient 6 Ischemic stroke prevention : why we do the things we do Investigations Ischemic stroke prevention : general measures Atrial fibrillation (A fib) Carotid stenosis Acute carotid occlusion Lacunar strokes Cervical arterial dissection Patent foramen ovale 7 Transient ischemic attack (TIA) Definition Etiology Presentation Differential diagnosis Clinical approach to a patient with suspected TIA Prognosis after TIA 8 Intracerebral hemorrhage (ICH) Definition