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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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