Ischemic stroke early assessment

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Early recognition of the signs of stroke is generally regarded as important. Only detailed physical examination and medical imaging provide information on the presence, type, and extent of stroke, and hence hospital attendance — even if the symptoms were brief — is advised.

Studies show that patients treated in hospitals with a dedicated Stroke Team or Stroke Unit and a specialized care program for stroke patients have improved odds of recovery.

Early assessment

Goal of initial assesment

 
 
 
 
 
 
 
 
 
 
 
 
Airway

Breathing

Circulation
 
AO2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early Diagnosis
 
History and PE
Initial diagnostic tests
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early assessment of ischemic stroke
 
 
 
 
Treatment plan
 
CO3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treatment of complications
 
DO2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Prognosis
 
EO2
 
 
 
 
 
 

Hemodynamic stability

  • Airway
  • Breathing
  • Circulation

Symptomatic relief

  • Pain
  • Fever
  • Dehydration
  • Infection

Early diagnosis and treatment plan

  • Non contrast CT or MRI
  • NIHSS Scoring/Glasgow coma scale
  • Antiplatelet therapy
  • Thrombolytic therapy
  • Mechanical thrombectomy

Underlying cause assessment

  • Cardioembolism
  • Large artery atherosclerosis
  • Small vessel disease

Prognosis
Maintainence therapy and secondary prevention

References

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