Early recognition of symtpoms
Emergency transport to hospital
Rapid triage in A&E
Urgent investigations
Management in a specialised stroke unit
Hypertension
50% dextrose injection to any patients with neurologic deficit and hypoglycemia
Aspirin should be used routinely (after CT scan is taken and cerebral haemorrhage is excluded), unless thrombolysis or anticoagulation are used, or if there is contraindication to aspirin.
Not used routinely
Consider in patients with AF and mild ischaemic stroke
Improve outcome if given within 3 hours of onset of acute ischaemic stroke
But also associated with increased risk of symptomatic intracerebral haemorrhage
(Streptokinase is NOT used because of increased mortality.)
Use only if:
Contraindication include:
Consider for young patients with space-occupying infarcts in nondominant hemisphere or cerebellum.
Corticosteroid is of no use and may be harmful
Neurosurgery to decompress haematomas of the posterior fossa, drain cerebral hemispheric haematoma or insert shunts.
Vasospasm and re-bleeding are the main causes of morbidity and mortality.
Risk highest in the first 24 hours.
Maintain blood pressure at pre-stroke level.
Early surgery
Give nimodipine
Post-stroke rehabilitation (different models including home-based care, inpatient, outpatient)
Treatment of associated psychiatric condition, especially depression
Secondary prevention
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Created | 20040516 |