Diagnosis Of Ischemic Stroke

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[edit] Diagnosis Of Ischemic Stroke

Depending on what the clinical situation is the physician may do tests such as an emergency CT or MRI scan. However, the most important step initially is the stabilization of the patient. Then it depends on many factors what the physician will do next.

For instance, if the patient has an advanced age (80 years or more) there might not be any merit in further testing as further interventional therapy is rarely indicated. This age group of patients has a guarded prognosis and any heroic measure tends to only increase the mortality, so that this group of patients might be best just treated conservatively. On the other hand, a younger group of patients would benefit greatly from tissue plasminogen activator (tPA) treatment, but this can only be given, if it is known that there is no sign and no danger of a hemorrhagic stroke. Reference 1 shows that a triphasic perfusion CT scan is such a tool to exclude hemorrhagic stroke safely before tPA is given intravenously.

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Strokes

Ischemic stroke

References:

1. KH Lee et al. Arch Neurol 2000 Jul 57(7): 1000-1008.

2. S Schmulling et al. Stroke 2000 Jul 31(7): 1552-1554.

3. D Jackson et al. Clin Rehabil 2000 Oct 14(5): 538-547.

4. ML Hackett et al. Neurology 2000 Sep 12; 55 (5): 658-662.

5. K Tsutsumi et al. J Neurosurg 2000 Oct 93( 4): 550-553.

6. IS Spetzler Surg Neurol 2000 Jun 53(6): 530-540.

7. G Lot et al. Acta Neurochir (Wien) 1999; 141(6): 557-562.

8. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 174.

9. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby Inc.

10. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

11. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier