tia | STROKE MANUAL

Carotid endarterectomy (CEA)

Surgical treatment of an acute ischemic stroke

ISCHEMIC STROKE / PREVENTION Carotid endarterectomy (CEA) David Goldemund M.D.Updated on 26/04/2024, published on 31/01/2023 [toc] carotid endarterectomy (CEA) is the gold standard for treating significant carotid artery stenosis (both symptomatic and asymptomatic) randomized trials have confirmed that CEA is more effective than conservative treatment: symptomatic stenosis (NASCET, ECST, joint data analysis of ACTS, NASCET, ... Read more

Patent foramen ovale (PFO)

ISCHEMIC STROKE / PREVENTION Patent foramen ovale (PFO) David Goldemund M.D.Updated on 26/03/2024, published on 25/01/2023 [toc] AAN guidelines 2020 - Practice Advisory Update Summary: Patent Foramen Ovale and Secondary Stroke Prevention before birth, the atrial septum is formed by two leaves. After birth, the pressure rises in the left atrium, and the two leaves ... Read more

TCD/TCCD bubble test

NEUROIMAGING / NEUROSONOLOGY TCD/TCCD bubble test David Goldemund M.D.Updated on 06/05/2024, published on 13/01/2023 [toc] Indications the TCD/TCCD bubble test (bubble study) is designed for the detection of right-to-left shunts, particularly Patent Foramen Ovale (PFO) a cost-effective, safe, and non-invasive imaging modality ideal for screening purposes Bubble study procedure the test simulates a paradoxical embolism ... Read more

Carotid artery web

ISCHEMIC STROKE Carotid artery web David Goldemund M.D.Updated on 14/03/2024, published on 12/01/2023 [toc] Definition the carotid artery web (CaW) is characterized by a thin fibrous membrane extending from the posterior wall of the carotid bulb into the lumen, just above the bifurcation it is considered a variant of fibromuscular dysplasia [Kim, 2019] various synonyms ... Read more

Protocols for thrombolytic therapy

ISCHEMIC STROKE / ACUTE THERAPY Protocols for thrombolytic therapy David Goldemund M.D.Updated on 21/04/2024, published on 06/01/2023 [toc] a complete thrombolytic protocol typically involves: confirming the diagnosis of ischemic stroke assessing eligibility criteria for IVT choosing a thrombolytic agent and the appropriate dose monitoring the patient and administering medications to prevent or treat complications this ... Read more

Extracranial-intracranial bypass

Extracranial-intracranial (EC-IC) bypass

ISCHEMIC STROKE / PREVENTION Extracranial-intracranial bypass David Goldemund M.D.Updated on 26/04/2024, published on 29/12/2022 ICA occlusion is responsible for ~15-25% of strokes ICA occlusion is associated with a 2-year stroke risk of about 10-15% (according to other sources, the risk is 5-20% per year) (Powers, 2011) the risk is even higher in the presence of ... Read more

TOAST classification of stroke

ADD-ONS / SCALES TOAST classification of stroke David Goldemund M.D.Updated on 20/04/2024, published on 28/12/2022 the exact etiology of ischemic stroke has implications for both prognosis and management a classification system for ischemic stroke subtype, mainly based on etiology, was developed for the Trial of Org 10172 in Acute Stroke Treatment (TOAST) the TOAST classification ... Read more

CT perfusion (CTP)

CTP mismatch and final infarction after succesfull recanalisation of dominant M2 occlusion

NEUROIMAGING / COMPUTED TOMOGRAPHY CT perfusion (CTP) David Goldemund M.D.Updated on 29/04/2024, published on 21/12/2022 [toc] brain infarction is the consequence of a localized decrease in cerebral blood flow (CBF) CT perfusion (CTP) can be used to assess cerebral blood flow and differentiate the penumbra (salvageable brain tissue) from the core (area of damaged brain ... Read more

AF-ROPE score

ADD-ONS / SCALES AND SCORES AF-RoPE score Anatomical-Functional Risk of Paradoxical Embolism score David Goldemund M.D.Updated on 05/11/2023, published on 11/12/2022 the discovery of a patent foramen ovale (PFO) in an individual stroke patient with an otherwise occult etiology is not synonymous with the diagnosis of paradoxical embolism the RoPE and improved AF-RoPE scores were ... Read more

Neuroimaging in pediatric stroke

ISCHEMIC STROKE Neuroimaging in pediatric stroke David Goldemund M.D.Updated on 27/02/2024, published on 09/12/2022 [toc] pediatric stroke is increasingly being recognized as an important cause of morbidity and mortality over 75% of children suffer long-term neurological deficits mortality ~ 10% 19% recurrence within 5 years it has a unique presentation (that may delay correct diagnosis) ... Read more