Condition Info - BotMed Application

ConditionName

Stroke

ConditionDescription

Symptoms

Sudden onset; 
Numbness or weakness in the face, arm, or leg, especially on one side of the body; 
Confusion, trouble speaking, or difficulty understanding speech; 
Trouble seeing in one or both eyes; 
Trouble walking, dizziness, loss of balance, or lack of coordination; 
Severe headache with no known cause;
Visual or auditory hallucinations or deficits;

Hemorrhagic stroke: 
Acute onset of “worst Headache of life”;
Nausea/vomiting;
Meningeal irritation;
Rapidly deteriorating LoC;
Also localizing neuro signs;

PhysicalFindings

Face weakness, LOWER part of the face may be paralyzed; Arm drift; Abnormal speech

ClinicalTests

Best I/T: CT without contrast;
PRIOR treatment! Excludes hemorrhage;

Most accurate: MRI;

ECG:
Damaged valves? -> surgery;
Thronbi? –> Heparin followed by warfarin to INR to 2-3;

Holter monitor for 24H if ECG is normal;

Carotid or transcranial doppler;
Cerebral angiogram;

CBC, coagulation labs, blood chemistry (sugar + electrolytes), lipids

RiskFactors

Hypertension;
DM;
Hyperlipidemia;
Tobacco;
History of stroke;
Smoking;
A-fib;

IsRedFlag

IsNPLEX

Consequence

Permanent condition;

ProgressionFromCondition

Carotid stenosis is a frequent cause of embolus;

TreatmentOptions

STOP SMOKING!

PharmOptions

Non-Hemorrhagic:
Best treatment in <3h since onset:
Thrombolytics
CI:
Hemorrhage on CT
Recent surgery
Anticoagulation
Recent hemorrhage
BP>185/100

>3h since onset:
ASA

If already on ASA: switch to clopidogrel

Hemorrhagic:
NOTHING
no anticoagulants! Vit K, fresh frozen plasma
Control BP

OT,ST, rehab

Treat underline condition:
BP: <140/90 mmHg
DM: A1C<7%

LDL <100mg/dL if carotid stenosis is cause

WebLink

https://www.merckmanuals.com/en-ca/professional/neurologic-disorders/stroke/overview-of-stroke