An 85-year-old patient was brought to the ER, BP: 180/100, right hemiparesis was seen. What is the next best step in management?
As given clinical features point towards stroke, doing NCCT is the next best step to confirm diagnosis & do appropriate management. If CT Scan shows: Hypodense lesion, point towards Acute ischemic stroke- Hyperdense lesion, point towards Hemorrhagic stroke Causes: Embolic stroke > cerebral thrombosis Causes: Hypeension, trauma, warfarin toxicity, cerebral amyloid angiopathy etc - DOC - Reteplase - Window period < 4.5 hr of symptom onset Brain angiography- window period 4.5-6hr Osmotherapy Ventriculostomy | (If fails) Hemicraniectomy Decompressive For hypeension crisis, Nicardipine/labetalol is used.
Reduce BP
NCCT
MRI
Aspirin 300mg and anticoagulants
FMGE 2019