doyoudig
Forum Guru
Topics: 144
Posts: 613
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ok
1. Pt w/ Evidence of Ischemic Stroke d/t Thrombosis & < 3 Hrs of Onset & No CI to tPA
--> Give tPA
2. Pt w/ Evidence of Ischemic Stroke d/t Thrombosis & > 3 Hrs of Onset or CI to tPA
--> ASA
ASA will also be given to prevent strokes after Pt is discharge if Pt still experiences Strokes than add Clopidrogel to aspirin
3. Pt w/ Evidence of Ischemic Stroke d/t Emboli (Hx of AFib, Cardiomyopathy, EKG) and No CI to Anticoagulation --> Heparin followed by Warfarin
This is Most Likly a TIA and More Likley seen in Younger
TIA
1. If d/t Thrombosis -- ASA?
2. If d/t Cadiac Source (Emboli) -- Hep followed by warfarin
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| Kamsi
Forum Guru
Topics: 103
Posts: 347
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Correct
Just want to add from Fischer QB that in TIA due to thrombosis, aspirin if not CI ,Clopidogrel if intolerant to aspirin,Ticlopidine if intolerant to aspirin and clopidogrel. Aspirin and Dipyridamole if patient has hx of TIA while on aspirin.
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| starcraftbw
Forum Senior
Topics: 13
Posts: 166
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you got everything down correctly....but i think we should do CT-head w/out contrast first before jumping into anything. Clinically evidence of ischemic stroke is almost imposible to differentiate from hemorrhagic stroke.
1) what if the pt developed cerebral edema secondary to ischemic stroke. what do you treat?
2) what do you treat when pt developed spasticity?
3)
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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agree Star definetly Initially
-- ABC's
--IV
--CT w/o Contrast
--EKG
....
1) what if the pt developed cerebral edema secondary to ischemic stroke. what do you treat? --- Steroids..???
2) what do you treat when pt developed spasticity? --???
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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ok, got that wrong
to decrease ICP d/t Ischemic Stroke
-- Elevate
-- Hyperventilate
-- Mannitol, Loops
Steroids more usefull in other casues of Cerebral Edema such as Maligancy/Masses...
pls correct me if wrong
spasticity -- Epileptic type of drugs ... not sure....
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| starcraftbw
Forum Senior
Topics: 13
Posts: 166
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From UW:
1) Elevate, Hyperventilate and supportive (NO mannitol or steroid...i have no idea why), if it doesnt work --> neurosurgery
2) Post stroke spasticity is treated with dantrolene cuz it’s peripheral and nonsedative 
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