Stroke update – Your questions answered

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Educational Activities (EA)
These are activities that expand general practice knowledge, skills and attitudes, related to your scope of practice.

RP
30 mins

Reviewing Performance (RP)
These are activities that require reflection on feedback about your work.

MO
0 mins

Measuring Outcomes (MO)
These are activities that use your work data to ensure quality results.

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Description

The questions answered in this podcast are listed below. They were compiled by GPs and health professionals around Australia.

  1. Can a blackout be a stroke?
  2. Can seizures be one of the differential diagnoses of the patient presenting with stroke?
  3. Can you comment on patients who present with lacunar infarctions, found incidentally, when GPs investigate a patient after a head injury?
  4. If a patient is young with hardly any cardiovascular risk factors, who should we refer them to?
  5. Are there any differences in presentations between haemorrhagic and thromboembolic strokes? How common are they, in whom do we see them?
  6. How many can be embolic and where are they generally from?
  7. Should patients with TIA symptoms be sent to ED for workup if there may be delays in investigations in GP setting?
  8. If a patient presents with a possible TIA, but is asymptomatic, what would you do? What should we investigate in general practice?
  9. I work an hour by ambulance from Ballarat Base hospital, whereas I can get a CT in about 20 minutes. Is it worth me getting a CT scan and considering antithrombotic? And without an MRI, if the CT does not show changes and symptoms resolved, would you start antiplatelets?
  10. Can you talk us through, antiplatelets, dual antiplatelets, which ones are better, when to use them and thrombolytic therapy?
  11. Any comments on GPs perceiving clopidogrel every second day or twice a week?
  12. Targets you want to be driving, particularly in younger patients.
  13. When it comes to antihypertensives, do neurologists have a preferred class of drugs?
  14. Do you ever do Apolipoprotein A?
  15. Comment on the use of coronary artery calcium score before the prescription of statins. Is it something neurologists do, or just cardiologists?
  16. In terms of driving guidelines post TIA stroke, the duration mentioned in the presentation, are these nationally accepted? And can GPs confidently advise these patients?
  17. Regarding all TIAs, should they be referred to a stroke physician even if all the measures you mentioned about CVD risk factors have been instituted?

 

Guest: Prof Bruce Campbell, Neurologist

Host: Dr David Lim, GP and Medical Educator

Total time: 38 mins

 

Last Updated: 5 Dec, 2023

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Prof Bruce Campbell

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Prof Bruce Campbell

Neurologist; Head, Neurology and Stroke, Royal Melbourne Hospital; Professor of Neurology, Department of Medicine, Royal Melbourne Hospital

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