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Hospital Medicine

Stroke

Preliminary Diagnosis: Stroke I. What imaging technique is first-line for this diagnosis Non-contrast CT of the brain. II. Describe the advantages and disadvantages of this technique for diagnosis of stroke. Advantages Relatively fast, inexpensive imaging modality. Highly specific and sensitive to evaluate and rule out intracranial hemorrhage. Disadvantages Exposes patients to ionizing radiation. Less sensitive…
Hospital Medicine

Stroke

Stroke I. Problem/Condition. Stroke is defined as the sudden loss of neurologic function due to a vascular event. This can include hemorrhage or ischemia as an underlying cause. The key elements in the initial management of stroke include differentiating between hemorrhagic and ischemic stroke, rapid evaluation for thrombolysis or embolectomy to attempt reperfusion of ischemic…
Evidence-Based Medicine

t-PA increases intracranial hemorrhage, but functional outcomes are inconsistent

Level 1: Likely reliable evidenceThe randomized placebo-controlled European Cooperative Acute Stroke Study III (ECASS III) evaluated alteplase (Activase, tissue-type plasminogen activator [t-PA]) in 821 patients aged 18-80 years with acute ischemic stroke (N Engl J Med. 2008;359:1317-1329). Alteplase 0.9 mg/kg (up to 90 mg) or placebo was given IV within 3-4.5 hours of non-severe stroke…
Web Exclusives

AHA issues guidelines to prevent repeat stroke

New recommendations to prevent future stroke in patients with TIA and stroke include treating hypertension, obesity, diabetes, and modifying lifestyle habits.
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