GEMC: Stroke Management in the 21st century: What Do You Need To Know?: Resident Training

Project: Ghana Emergency Medicine Collaborative Document Title: Stroke Management in the 21st Century: What Do You Need to Know? Author(s): Rashmi Kothari (Michigan State University), MD 2012 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/

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5 Reference: Tissue Plasminogen Activator for Acute Ischemic Stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group N Engl J Med 1995; 333:1581-1588. http://www.nejm.org/doi/full/10.1056/NEJM199512143332401.

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Facial Droop

Normal: Both sides of face move equally Abnormal: One side of face does not move at all

Arm Drift

Normal: Both arms move equally or not at all Abnormal: One arm drifts compared to the other

Speech

Normal: Patients use correct words with no slurring Abnormal: Slurred or inappropriate words or mute

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p Value

LOS (mean days +SD)

10.88+10.04 12.41+11.10 0.02

Disposition 0.002*

Home 151 (48%) 112(36%)

Rehab unit 91 (29%) 115 (37%)

Nursing home 22 (7%) 39 (13%)

Dead 35 (11%) 40 (13%)

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* compared home to all other dispositions Neurology 1998;50 33

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Treatment ICH Mortality

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ASA NA 22%

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35