Initial management
Code Stroke
- CT head wo to rule out bleed
- MRI after 24 hours if no bleed
- Call neurosurgery and repeat CT head in 24 hours if hemorrhagic stroke
Tier 1
- tPA within 3-4 hours
- Observation in ICU for 24 hours then transfer to floor
- BP goal: <180 in 1st 24 hours, then normotension once on floor
- After 24 hours: statin only, repeat CT, then add antiplatelet or anticoagulation
Tier 2
- Thrombectomy within 24 hours
- BP goal: <180 in 1st 24 hours, then normotension once on floor
- Antiplatelet and anticoagulation?
No intervention
- Permissive HTN 160-180 in first 48 hours, then normotension