Stroke
20. Oropharyngeal Angioedema: Management Protocol
. Repeatedly examine oropharynx, watching for edema (may be subtle swelling of lip or tongue just on one side).
21. What are the risks of TPA therapy?
. Symptomatic intracranial hemorrhage rate 6.4% (i.e., 1 in 16; 95% CI 3.5–9.2%) vs. 0.6% in placebo.
22. What are the benefits of TPA therapy?
The percentage of patients with excellent outcome
(Rankin 0–1) is increased by about 15% absolute, or 50% relative. The percentage with bad outcome (dead or Rankin 4–5) is reduced, even if you include the patients who bleed.
23. Who benefits?
Subgroups:
. All stroke subtypes benefit.
. Both mild (NIHSS<7) and severe (NIHSS>15) stroke patients benefit.
24. Who is more likely to bleed?
. Patients with more severe stroke.
. Patients with extensive CT changes, elevated BP, glucose, and temperature, and those of advanced age.
