Stroke; Roadside to Resus
Summary
This podcast episode provides an in-depth look at stroke recognition, starting with definitions of stroke and TIA, and exploring the pathophysiology of ischemic versus hemorrhagic strokes. It details the symptoms associated with anterior and posterior circulation strokes, emphasizing the difficulty in diagnosing the latter. The discussion covers key risk factors, common stroke mimics, comprehensive assessment techniques (history, neurological exam), and the effectiveness of pre-hospital and in-hospital screening tools like FAST and ROSIER. Finally, the hosts examine the role and limitations of CT and MRI imaging, alongside NICE guidelines, in the acute stroke pathway.Episode description
Stroke is a common presentation to all Emergency Health care providers, with around 150,000 strokes occurring in the UK each year! Our impact and treatment can be hugely significant and in this podcast we're going to conver the topic in some depth, and importantly cover some of the new Guidance published by NICE in their 'Stroke and transient ischaemic attack in the over 16's diagnosis and initial management' document that was published in May of this year.
We'll be running through
- Definition
- Pathophysiology
- Territories
- Risk factors
- Assessment; both prehospitally and in hospital
- Stroke mimics
- Investigations
As always we'd love to hear any thoughts or comments you have on the website and via twitter.
Enjoy!
References
RCEMLearning; RCEM Belfast Vertigo
Acute Stroke Lecture notes; LITFL
Are you at risk of a Stroke; Stroke Association
Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention.Hill VA. Semin Neurol. 2017
A systematic review of stroke recognition instruments in hospital and prehospital settings. Rudd M. Emerg Med J. 2016
Acute Stroke Diagnosis.Kenneth S. Yew. Am Fam Physician. 2009