Articles / Clinical Conversations: Acute Stroke Treatments and Secondary Stroke Prevention | Part One
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Neurologist; Head, Neurology and Stroke, Royal Melbourne Hospital; Professor of Neurology, Department of Medicine, Royal Melbourne Hospital
This is part one of this series. Read Part 2 >>
Practice points
• The first message we promote are the most common signs of stroke. So F is for face droop, A is for arm, if the arm is weak, S is for speech, if it is slurred or incomprehensible, T is for time to call triple zero.
• Do not try to give a stroke patient anything orally, do not to give them aspirin as it could be a haemorrhage, do not treat hypertension.
• If you get a focal deficit that is sudden onset (the average duration is about ten minutes,), the patient needs exactly the same workup as a stroke.
• Look at the carotid arteries, look for atrial fibrillation, start anti-platelet therapy really quickly. Brain imaging is very worthwhile, such as a CT scan to exclude a bleed; an MRI should be normal in a TIA.
• Endovascular thrombectomy, physically removing the clot via an angiogram, is of major benefit for patients with a large artery occlusion, such as the middle cerebral carotid territory or the vertebral artery, within six hours of onset.
• The proportion of stroke patients who benefit from active management does drop off rapidly with time.
Based on this educational activity, complete these learning modules to gain additional CPD.
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writer
Neurologist; Head, Neurology and Stroke, Royal Melbourne Hospital; Professor of Neurology, Department of Medicine, Royal Melbourne Hospital
Yes, if the referral process involves meaningful collaboration with GPs
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