Stroke and TIA management

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Learn more about the presentation of stroke here!

Include in assessment

  • History
    • Exact onset/when last well
    • Any change/progression in symptoms
    • Risk factors (e.g. smoking, hypertension, cardiovascular disease, AF)
  • Examination
    • Full neurological exam
    • Systemic
      • Pulse (AF)
      • Heart sounds
      • Carotid bruits
      • Bruising/bleeding
    • Risk factor signs
      • Xanthelasma
      • Corneal arcus

Management algorithm

Long-term drugs

  • Antihypertensives
  • Clopidogrel 75mg OD after 300mg loading dose (or anticoagulation if patient is in AF – but wait 2 weeks after stroke) 
  • Statin â€“ but wait 48 hours after stroke

Reference: NICE ‘NG128 Stroke and transient ischaemic attack in over 16s: diagnosis and initial management’ 2022

Questions

What is the DVLA advice with regards to stroke and driving?

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Which scoring system may be used in stroke to help make decisions about thrombolysis?

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How is a haemorrhagic stroke managed?

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Try some OSCE stations

  1. Transient ischemic attack
  2. Stroke
  3. Find more here

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