Stroke Medicine Advice

29/01/2023

Consider Isolated Hypoglossal nerve palsy rare complication of intubation in GA
Hypoglossal Neuropraxia ( Left )
Rule out Carotid dissection and stroke
Neuropraxia does improve in 2-6 months time

01/11/2022

Thrombolysis is very effective in LVO
62 years old presented with one hour history of dense right sided weakness and expressive dysphasia NIHSS score 17 pre CT and 20 post CT CTA and Perfusion
Symptoms improved soon after thrombolysis (alteplase)with complete recovery NIHSS 0
Patient did not require Thrombectomy

17/08/2022

27/05/2022

70yrs old man presented with two day history of confusion. MRI brain Dwi and ADC images. Diagnosis ? Turn out to be Lymphoma.

19/04/2022

Consider Multiple sclerosis in patients 50years

05/03/2022

Onset of symptoms really important in differentiating Stroke / TIA from mimics.
History is very very very important
EASY GUIDE
Development of symptoms
Abrupt: Vascular. Stroke/ TIA
Over Minutes: Migraine
Over Seconds : Epilepsy
Over hours / days: Infection/ Tumour
Over days and weeks: Tumour
Stereo type frequent symptoms, and marching of symptoms are not the features of TIA/ Stroke.

11/08/2021

Relaxing mode

05/06/2021

I have attached the link of stroke masterclass for doctors, medical students and health care professionals.

Stroke Masterclass 18th Feb 2021

VIRTUAL STROKE MASTERCLASSTHURSDAY 18th February 2021Topics New Antithrombotic Agents: are they better for Secondary StrokePrevention? How Stroke Nurses ca...

15/05/2021

HIGH BLOOD PRESSURE AND STROKE
High blood pressure is single contributing factor in half of all types of stroke
It’s thickened the blood vessels which can lead to ischaemic stroke or it can weekend the blood vessel which can lead to haemorrhagic stroke.
Ideal BP should be in between 90/60 to 120/ 80
If you are diabetic BP should be not more then 130/80
HOW TO TREAT
Control weight
Stop smoking
Regular exercise
Healthy diet
If still high then Medication

09/05/2021

Stroke treatment in acute stage:
Thrombolysis
in acute ischaemic stroke with in 4.5hr. Thrombolysis is by injecting clot busting drug alteplase if there is no contraindication.
Mechanical thrombectomy
with in 6hrs
In case of large clot obstructing the large vessel in the brain after identification by the stroke physician with help of imaging, neuro-interventional radiologist removes the clot mechanically by accessing the clot through groin
Neuro surgical treatment
Removing blood in haemorrhagic stroke in some cases
Clipping and coiling of leaky blood vessel in haemorrhagic stroke or Subarachnoid haemorrhage
Hemicranectomy
After assessment by stroke physician. Neuro surgeon Remove part of the skull so that brain can expand in massive ischaemic stroke and it improves the mortality if it is done with in 48 hrs
Aspirin 300mg in ischaemic stroke if Thrombolysis window has passed and no indication for thrombectomy.