By Ji Y. Chong
"Part of the "What Do I Do Now?" sequence, Cerebrovascular sickness a case-based method of disguise universal and significant themes within the exam, research, and administration of stroke, embolism, thrombosis, hemorrhage, and different severe displays of cerebrovascular affliction. every one bankruptcy offers a dialogue of the prognosis, key issues to recollect, and chosen references for additional interpreting. For this edition, all circumstances and references were up-to-date and new circumstances were extra together with: Ischemic stroke in melanoma, posterior reversible encephalopathy syndrome (PRES), fundamental angiitis of the important worried method, symptomatic spinal vascular malformation, anoxic mind damage, and vascular dementia. Cerebrovascular sickness is an interesting number of thought-provoking circumstances which clinicians can make the most of after they stumble upon tricky sufferers. the amount can also be a self-assessment device that checks the reader's skill to respond to the query, "What do I do now?"" -- Read more...
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Extra info for Cerebrovascular disease
She was noted to have a left homonymous hemianopia, left facial droop, mild left arm and leg weakness, and some sensory neglect of the left side. 1). What do I do now? 1 MRI DWI showing right temporal and insular infarct. SECONDARY STROKE PREVENTION AFTER STROKE DUE TO CAROTID STENOSIS Patients with stroke or TIA referable to a carotid artery with >50% stenosis should be considered for revascularization. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) was an important randomized trial of CEA versus medical therapy in patients with symptomatic carotid stenosis.
Dual antiplatelet therapy with ASA and clopidogrel is associated with increased risk of bleeding and death. Further Reading Amarenco P, Bogousslavsky J, Callahan AIII, et al. High-dose atorvastatin after stroke or transient ischemic attack, N Engl J Med 2006;355:549–559. Benavente OR, Coffey CS, Conwit R, et al. Blood-pressure targets in patients with recent lacunar stroke: The SPS3 trial. Lancet 2013;382:507–515. Benavente OR, Hart RG, McClure LA, et al. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke.
KEY POINTS TO REMEMBER • Preventing recurrent events after a lacunar stroke includes aggressive control of vascular risk factors, particularly blood pressure control. • Antiplatelet monotherapy should be instituted with ASA, ASA with extended-release dipyridamole, or clopidogrel. • Dual antiplatelet therapy with ASA and clopidogrel is associated with increased risk of bleeding and death. Further Reading Amarenco P, Bogousslavsky J, Callahan AIII, et al. High-dose atorvastatin after stroke or transient ischemic attack, N Engl J Med 2006;355:549–559.