NeuroResidents
TIA
Impression: Acute Ischemic Stroke: - Manifestations: *** - NIHSS: *** - PTA antithrombotic: *** - TNK/EVT: *** - Presumed Etiology: *** Plan: Stroke acute management: - Admit to stroke unit - Frequent neuro-checks (q4h) - Permissive HTN for 24h - Baseline EKG - Basic labs: CBC, CMP, coagulation panel and troponin - Bedside swallow evaluation - Head of bed > 30 degrees for aspiration precautions Stroke workup: -CTH: *** -CTA: *** -MRI: *** -TTE: *** -LDL: *** -A1C:*** -Continuous cardiac telemetry Secondary prevention of stroke: -Aspirin 81mg daily -Atorvastatin 40 mg daily (long-term goal LDL < 70) -Tight glucose control (long-term goal HgbA1c < 6%) -Stroke education and counseling Stroke rehabilitation: -PT, OT, ST consults -Consulted case manager for discharge disposition Other medical issues: HTN: *** DM: *** Prophylaxis: SCDs (DVT), heparin 5000u q8h Patient was staffed with the stroke attending during morning rounds.
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