Acute Stroke Management with IV Thrombolysis

Stroke

• Acute Stroke is defined as Sudden onset weakness affecting one or more region of body and lasting more than 24 hours.

Clinical features

• Deviation of face
• Slurring of speech
• Weakness / Inability to move arm or leg of one side of body.
• Loss of balance
• Double vision
• Headache with associated vomiting
• Loss of consciousness

Risk Factors

• Heart disease
  • Atrial Fibrillation, Valvular Disease, MI, endocarditis
• Hypertension
• Smoking
• Diabetes/Metabolic Syndrome
• Dyslipidemia
• Pregnancy
• Drugs – recreational / medicinal
• Bleeding Disorders/Anticoagulant Use

Classification of Stroke

Ischemic :

• Inadequate blood supply (oxygen & nutrients) to an area of the brain

Hemorrhagic:

• Leakage of blood into the closed cranial cavity
• Direct damage to tissue by compression/edema

Evaluation

• Blood investigation ( to evaluate for metabolic risk factors )
• CT Scan /MRI of brain
• CT / MR angiography of brain vessels
• 2D Echocardiogram and ECG

Management-

• Acute Stroke management – IV Thrombolysis/ Thrombectomy.
• Modification of risk factors
• Antiplatelets/ anti coagulants , Statins
• Physiotherapy and rehabilitation.