CHAPTER I
1. Introduction
2. Stroke in the emergency room
2.1 Is this a stroke?
2.1.1Definition
2.1. 2. Diagnosis
2.1.3 Stroke mimics
2.2 What type of stroke?
3. What to do first
3.1 Airway – breathing – circulation (ABCs)
3.2 What was the time of onset?
3.3 How bad are the symptoms now?
3.4 Do a non-contrast head CT
3.5 If the CT shows no blood, try to get the artery open
3.6 Recommended diagnostic evaluation
4. Ischemic stroke
4.1 Definition
4.2 Etiology
4.3 Diagnosis
4.4 The four components of ischemic stroke care
4.5 Acute therapy and optimization of neurological status
4.6 Etiological work-up for secondary prevention
4.7 Prevention of neurological deterioration or medical
4.8 Complications
4.9 Stroke recovery and rehabilitation
4.10 Ischemic stroke outcome
4.11 General timeline
5. TPA protocol
5.1 TPA indications
5.2 Strong contraindications
5.3 Relative contraindications
5.4 Procedure
5.5 Dose
5.6 Sample post-TPA orders
5.7 Risks vs. benefits of TPA
5.8 Unproven therapies
6. Neurological deterioration in acute ischemic stroke
6.1 Probable causes
6.2 Initial evaluation of patients with neurologic deterioration
6.3 Stroke enlargement
6.4 Drop in perfusion pressure
6.5 Recurrent stroke
6.6 Cerebral edema and mass effect
6.7 Hemorrhagic transformation
6.8 Metabolic disturbance
6.9 Seizure
6.10 Symptom fluctuations without a good cause
6.11 The uncooperative patient
7. Ischemic stroke prevention: why we do the things we do
7.1 Investigations
7.2 Ischemic stroke prevention: general measures
7.3 Atrial fibrillation (A fib)
7.4 Carotid stenosis
7.5 Acute carotid occlusion
7.6Lacunar strokes
7.7 Cervical arterial dissection
7.8 Patent foramen ovale
8. Transient ischemic attack (TIA)
8.1 Definition
8.2 Etiology
8.3 Presentation
8.4 Differential diagnosis
8.5 Clinical approach to a patient with suspected TIA
8.6 Prognosis after TIA
9. Intracerebral hemorrhage (ICH)
9.1 Definition
9.2 Etiology
9.3 Presentation
9.4 Diagnosis and evaluation
9.5 Management
9.6 Prognosis and outcome
10. Subarachnoid hemorrhage (SAH)
10.1 Definition
10.2 Epidemiology
10.3 Presentation
10.4 Diagnosis
10.5 Ruptured aneurysms: management
10.6 Prognosis
10.7 Admission sequence
10.8 Unruptured aneurysms
11. Organization of stroke care
11.1 Timely care
11.2 Stroke units
11.3 Stroke centers
11.4 Stroke teams
12. Rehabilitation
12.1 Secondary stroke prevention
12.2 Prevention of medical complications
12.3 Multidisciplinary rehabilitation team
12.4 Discharge planning
CHAPTER II
1. Numbers and calculations
2. IV TPA dosing chart
3. Sample admission orders
4. Sample discharge summary
5. Stroke radiology
6. Transcranial Doppler ultrasound (TCD)
7. Heparin protocol
8. Insulin protocol
9. Medical complications
10. Brainstem syndromes
11. Cerebral arterial anatomy
12. Stroke in the young and less common stroke diagnoses
13. Brain death criteria
14. Neurological scales
15. Recommended reading
16. References and websites
