STROKE REHABILITATION
QUESTIONS AND PROVEN ANSWERS
What tool can be used to rapidly assess stroke patients and what does it identify? ANSW✅✅·
National Institute of Health Stroke Scale (NIHSS)
· Those who will benefit from thrombolysis
What are the aims of investigations into stroke? ANSW✅✅o Define arterial territory
o Define pathology
o Exclude stroke mimics
o Guide further investigations
o Aids treatment strategies
o Aids prognostication
What are RCP guidelines for stroke investigations? ANSW✅✅all strokes to be scanned with 24hrs
What are indications for an urgent scan? ANSW✅✅o ?Thrombolysis
o On anti-coagulation
o Bleeding tendency
o Unexplained progressive/fluctuating symptoms
o Depressed conscious level
o Suspicion of SAH
What are Early signs of infarct on CT head? ANSW✅✅o Hyperdense MCA
o Loss of grey-white differentiation
o Sulcal effacement
o Loss of insular ribbon
What are positives and negatives of using an MRI instead of CT head? ANSW✅✅-
o Lessaccesbile
, o Longerprocedure
o Contraindications
+
o More detailed, better images
o Define pathologies and arterial supplies
What are blood investigations for stroke? ANSW✅✅o FBC, U&E, LFT, TFT
o Glucose
o Lipids
o Coagulation
o ESR
o Thrombophilia screen
o Vasculitic screen
What may be found in ECG in stroke? ANSW✅✅Signs of AF, LVH or ischaemic changes
What may be found in echo in stroke? ANSW✅✅· Look at Echo for valvular disease (SBE), mural
thrombus, LVH & PFO
What are Indications for thrombolysis using Alteplase (0.9mk/kg)? ANSW✅✅o Up to 4.5 hours
o Clear time of onset
o Clinical symptoms & signs of acute stroke
o Haemorrhage excluded
What are Contraindications for thrombolysis? ANSW✅✅o Rapidly improving or minor stroke
symptoms
o Stroke or serious head injury 3 months
o Major surgery, obstetrical delivery, external heart massage in last 14 days
o Seizure at onset of stroke
o Severe haemorrhage in last 21 days
o Bleeding tendency
QUESTIONS AND PROVEN ANSWERS
What tool can be used to rapidly assess stroke patients and what does it identify? ANSW✅✅·
National Institute of Health Stroke Scale (NIHSS)
· Those who will benefit from thrombolysis
What are the aims of investigations into stroke? ANSW✅✅o Define arterial territory
o Define pathology
o Exclude stroke mimics
o Guide further investigations
o Aids treatment strategies
o Aids prognostication
What are RCP guidelines for stroke investigations? ANSW✅✅all strokes to be scanned with 24hrs
What are indications for an urgent scan? ANSW✅✅o ?Thrombolysis
o On anti-coagulation
o Bleeding tendency
o Unexplained progressive/fluctuating symptoms
o Depressed conscious level
o Suspicion of SAH
What are Early signs of infarct on CT head? ANSW✅✅o Hyperdense MCA
o Loss of grey-white differentiation
o Sulcal effacement
o Loss of insular ribbon
What are positives and negatives of using an MRI instead of CT head? ANSW✅✅-
o Lessaccesbile
, o Longerprocedure
o Contraindications
+
o More detailed, better images
o Define pathologies and arterial supplies
What are blood investigations for stroke? ANSW✅✅o FBC, U&E, LFT, TFT
o Glucose
o Lipids
o Coagulation
o ESR
o Thrombophilia screen
o Vasculitic screen
What may be found in ECG in stroke? ANSW✅✅Signs of AF, LVH or ischaemic changes
What may be found in echo in stroke? ANSW✅✅· Look at Echo for valvular disease (SBE), mural
thrombus, LVH & PFO
What are Indications for thrombolysis using Alteplase (0.9mk/kg)? ANSW✅✅o Up to 4.5 hours
o Clear time of onset
o Clinical symptoms & signs of acute stroke
o Haemorrhage excluded
What are Contraindications for thrombolysis? ANSW✅✅o Rapidly improving or minor stroke
symptoms
o Stroke or serious head injury 3 months
o Major surgery, obstetrical delivery, external heart massage in last 14 days
o Seizure at onset of stroke
o Severe haemorrhage in last 21 days
o Bleeding tendency
