Dr. Edward C. Jauch
Department of Emergency Medicine
University of Cincinnati College of Medicine
Greater Cincinnati / Northern Kentucky Stroke Team

Contents:

A Look at Current Stroke Treatment

• What's Changed in 2000?
• What Has Not Changed
• Acute Stroke - Where are we today?
• Models for the "Golden Hour"
• Trauma - example
• Acute Myocardial Infarction - example
• Forces of Change
• Organized Stroke Care Saves Lives
• Cost Effectiveness for rt-PA in Acute Ischemic Stroke

Treatment Guidelines & Recommendations - Part I

• NIH National Symposium Recommendations
• Stroke Chain of Survival & Recovery
• Dispatch & Delivery: Transport & Management
• Cincinnati Pre-Hospital Stroke Scale
• NIH Stroke Scale
• Preparation
• American Heart Association Recommendations
• True Time of Onset
• Stroke Risk Factors

Treatment Guidelines & Recommendations - Part II

• Early CT Changes in Ischemic Stroke
• Differential Diagnosis
• What are the Options?
• Treatment Based on CT Findings
• Exclusions to Thrombolytics
• Pretreatment BP Treatment
• Treatment Considerations: Who will benefit from rt-PA?
• Factors Associated with Increased Risk of ICH

Treatment Guidelines & Recommendations - Part III

• Symptomatic Hemorrhages by NIH Stroke Scale in NINDS Trial
• rt-PA Dosing
• Intra-arterial Thrombolytic Efficacy vs. Time of Delivery
• Stroke Treatment – Aspirin
• Stroke Treatment – Heparinoids

Post-Treatment Guidelines & Recommendations

• Post Treatment Care - Antihypertensive Therapy
• ICH Contingency Plan
• Management of Seizures
• Pneumonia After Stroke
• Rehabilitation
• What do you need to treat?

Case Study

• Case Study - History ,timeline and initial CT Findings
• Case Study - 24 Hour Follow-up

Appendix

• References

 

About this Presentation:

This presentation was written by Dr. Edward C. Jauch of the Greater Cincinnati / Northern Kentucky Stroke Team at the University of Cincinnati College of Medicine.

Last Revised: March 26, 2001