#Order
▪️Imp: TIA or minor stroke
▪️Con: Emergency
▪️Diet: PO
▪️Act: CBR- bed sides up
▪️Pos: Sup/ head elevated (اگر شک به ICP بالا داریم)
▪️Check V/S
▪︎IV line fix
▪️BS glucometry
▪︎CBC, PT and PTT, serum electrolytes, creatinine, fasting blood glucose or HbA1c, lipids, and (as indicated for selected patients) ESR and CRP. Trop(some reference suggested)
▪︎Brain imaging with diffusion-weighted MRI (preferred) or CT to identify infarction and rule out nonischemic causes
▪︎Cardiac evaluation
(ECG, cardiac monitoring, echocardiography) to identify atrial fibrillation or other cardioembolic source.
▪︎Vascular imaging of extracranial and intracranial large arteries with MRA or CTA to identify large artery cause
▪️Start antiplatelet therapy immediately while the evaluation is in progress. (hemorrhage should be ruled out).
*The duration of DAPT is typically limited to 21 days for patients with high-risk TIA or minor ischemic. Thereafter, antiplatelet treatment with one of them alone should be continued indefinitely.
* If ABCD2 score < 4 (low risk)
▫️Tab Aspirin 325 mg PO daily
* If ABCD2 score ≥ 4 (high risk)
▫️Consider dual antiplatelet therapy.
*Load with Aspirin 325 mg chewed, followed by ASA 81 mg PO daily,
plus
*Clopidogrel 300 mg PO followed by 75 mg daily.
▪︎Also consider:
▫️CTA brain and neck
To check for large vessel occlusion for potential thrombectomy,
Determine if there is carotid stenosis that warrants endarterectomy urgently
▫️Pregnancy test
▫️CXR (if infection suspected)
▫️UA (if infection suspected)
▫️Utox (if ingestion suspected)
▪︎مشاوره نورولوژی/ قلب برای اکو
🔹️Appendix:
▪️Immediate antithrombotic treatment of (TIA) and ABCD2 (score)
▪︎contraindications of anticoagulation(table)
#Episode_47