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  • Stroke TIA Management

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    Sara Kalim
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    This document provides guidelines for evaluating and treating patients presenting with symptoms of stroke or transient ischemic attack (TIA). It outlines evaluating symptoms and timing to determine if the patient should be referred to a TIA clinic within 24 hours or 7 days. For ischemic stroke, it recommends CT scan within 1 hour, and if within 4.5 hours considers treating with alteplase. For all patients, it recommends starting secondary prevention with antihypertensives, statins, and anticoagulants or antiplatelets depending on whether atrial fibrillation is present.

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    This document provides guidelines for evaluating and treating patients presenting with symptoms of stroke or transient ischemic attack (TIA). It outlines evaluating symptoms and timing to determine if the patient should be referred to a TIA clinic within 24 hours or 7 days. For ischemic stroke, it recommends CT scan within 1 hour, and if within 4.5 hours considers treating with alteplase. For all patients, it recommends starting secondary prevention with antihypertensives, statins, and anticoagulants or antiplatelets depending on whether atrial fibrillation is present.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views1 page

    Stroke TIA Management

    Uploaded by

    Sara Kalim
    This document provides guidelines for evaluating and treating patients presenting with symptoms of stroke or transient ischemic attack (TIA). It outlines evaluating symptoms and timing to determine if the patient should be referred to a TIA clinic within 24 hours or 7 days. For ischemic stroke, it recommends CT scan within 1 hour, and if within 4.5 hours considers treating with alteplase. For all patients, it recommends starting secondary prevention with antihypertensives, statins, and anticoagulants or antiplatelets depending on whether atrial fibrillation is present.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    Carotid Doppler

    IMAGE
    (not CT!)
    Symptoms Symptoms of Symptoms
    still ongoing stopped +
    stroke / TIA <7d ago Refer to TIA clinic within 24 hours
    Symptoms
    REFER
    onset?
    >7d ago Refer to TIA clinic within 7 days
    Stroke TIA +

    MANAGE

    CT within 1 hour ISCHAEMIC STROKE

    INCONCLUSIVE HAEMORRHAGIC STAT COMMENCE 2RY PREVENTION


    STROKE <4.5 hours >4.5 hours

    - MRI - If pt is on anticoagulants ? reverse ALTEPLASE ANTIHYPERTENSIVE


    ALL PATIENTS IF HYPERTENSIVE THERAPY
    - Consider evacuation by neurosurgery
    - Control blood pressure

    Lower STATINS
    Prevent Recurrence + Cholesterol lifelong

    ANTICOAGULANT
    LOOK AT AFIB STATUS AFIB PRESENT in non-disabling ischaemic stroke and in TIA DOACs if not suitable Warfarin
    THERAPY

    in disabling ischaemic stroke with afib, defer anticoagulant therapy for 2 weeks, and give Aspirin 300mg in the interim

    Aspirin 75mg OD Aspirin 75mg OD


    ANTIPLATELET Aspirin 300mg Clopidogrel 75mg OD
    AFIB ABSENT followed by if not suitable + if not suitable OR
    THERAPY for 2 weeks lifelong
    Dipyridamole 200 MR BID Dipyridamole 200 MR BID

    You must wait for 24 hours between Aspirin and alteplase

    For example: in patients with ischaemic stroke <4.5 hours who do not
    have afib, or in those with disabling ischaemic stroke who have afib

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