1. Acute Ischaemic Stroke
Dr. Evelyn Chan
Acute Ischaemic Stroke

2. What is stroke?

3. What is a TIA?

4. What kind of stroke is it?

5. Can you tell which part of the brain is damaged?
Clinical examination
Different types of stroke

6. Different kinds of stroke: TACI, Total anterior circulation infarct
PACI, Partial anterior circulation infarct
LACI, Lacunar infarct
POCI, Posterior circulation infarct
The Oxford Community Stroke Project classification , OCSP

7. TACI Total Anterior Circulation Infarct
What 3 components are present?

8. PACI Partial Anterior Circulation Infarct
Define PACI

9. LACI Lacunar Anterior Circulation Infarct
Give the clinical syndromes of a LACI.

10. POCI Posterior circulation Infarct
What symptoms are classified under POCI?

11. What are the causes of ischaemic stroke?

12. Swallowing Test
What is a swallowing test?

13. Investigations 1. What investigations to confirm the diagnosis?
2. What investigations to determine the stroke mechanism?
3. How to risk stratify and prognosticate?
4. How to identify potentially treatable large obstructive lesions of the cerebrovascular circulation?

14. Management: general measures
Oxygen and Airway Support
Adequate tissue oxygenation is imperative to prevent hypoxia and potential worsening of the neurological injury
Observation
Vital signs and GCS
What is GCS?

15. Mobilisation
How and when to mobilise the patient?

16. Antiplatelet agents
Which antiplatelets to use?

17. How to treat recurrent ischaemic strokes?
How to treat cardioembolic strokes?

18. Lipid lowering therapy
Statins

19. Hypertension
How to manage hypertension in acute stroke?

20. What are the causes of high BP in an acute stroke?

21. Hyperglycaemia
How and when do you treat hyperglycaemia?
Why treat?

22. Raised intracranial pressure:
How to manage?

23. Thank you