Front Panel Painting “LIFE” By William T Chua MD
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Emergent<br />
Diagnostics<br />
Early Specific<br />
Treatment<br />
CT-scan<br />
confirmed<br />
Place of<br />
Treatment<br />
Complete blood count (CBC)<br />
Blood sugar (CBG or RBS)<br />
Electrocardiogram (ECG)<br />
PT/PTT<br />
Non-cardioembolic<br />
(Thrombotic, Lacunar)<br />
Aspirin 160-325<br />
mg/day start as early<br />
as possible and<br />
continue for 14 days<br />
For secondary<br />
prevention, see under<br />
“Delayed Management<br />
and Treatment”<br />
Neuroprotection<br />
Early rehabilitation<br />
once stable within 72<br />
hours<br />
Ischemic<br />
Cardioembolic<br />
Consider careful<br />
anticoagulation with IV<br />
heparin or SQ low<br />
molecular-weight<br />
heparin (LMWH) for<br />
those high risk with<br />
early recurrence (e.g. AF<br />
with thrombus, valvular<br />
heart disease or MI)<br />
or<br />
Aspirin 160-325 mg/day<br />
(if anticoagulation is not<br />
possible or<br />
contraindicated)<br />
Neuroprotection<br />
(Appendix V-D)<br />
Early rehabilitation once<br />
stable within 72 hours<br />
If infective endocarditis<br />
is suspected, give<br />
antibiotics and do not<br />
anticoagulate<br />
Non-contrast CT scan of the brain or<br />
MRI-DWI as soon as possible<br />
If ICH, compute for hematoma<br />
volume<br />
Hemorrhagic<br />
Early neurology and/ or<br />
neurosurgeon consult<br />
for all ICH is<br />
recommended<br />
Monitor and maintain<br />
BP: Target MAP of 110<br />
or SBP of 160<br />
Neuroprotection<br />
Early rehabilitation once<br />
stable within 72 hours<br />
Give anticonvulsants for<br />
clinical seizures and<br />
proven subclinical or<br />
electrographic seizures.<br />
Prophylactic AEDs are<br />
generally not<br />
recommended<br />
Steroids are not<br />
recommended<br />
Monitor and correct<br />
metabolic parameters<br />
Correct coagulation /<br />
bleeding abnormalities<br />
Follow recommendations<br />
for neurosurgical<br />
intervention<br />
For aneurysmal SAH,<br />
refer to specific chapter<br />
Admit to Hospital: Acute Stroke Unit / Regular Room<br />
93<br />
Acute Stroke<br />
Treatment
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