Cerebrovascular Disease

doi:10.1017/CBO9780511547256.013

12 - Cerebrovascular Disease

from SECTION III - SPECIFIC NEUROLOGICAL CONDITIONS

Published online by Cambridge University Press: 06 August 2009

Michael R. Frankel ,

Marc Chimowitz ,

Sam Josvai ,

Rashmi U. Kothari and

Sid M. Shah

Edited by

Sid M. Shah and

Kevin M. Kelly

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Michael R. Frankel: Affiliation:
Department of Neurology Grady Memorial Hospital Atlanta, Georgia
Marc Chimowitz: Affiliation:
Department of Neurology Grady Memorial Hospital Atlanta, Georgia
Sam Josvai: Affiliation:
Kalamazoo Center for Medical Studies/MSU Emergency Medicine Residency Program Kalamazoo, Michigan
Rashmi U. Kothari: Affiliation:
Kalamazoo Center for Medical Studies/MSU Emergency Medicine Residency Program Kalamazoo, Michigan
Sid M. Shah: Affiliation:
M.D. Ingham Regional Medical Center Sparrow Hospital/MSU, Emergency Medicine Residency Program Lansing, Michigan
Sid M. Shah: Affiliation:
Michigan State University
Kevin M. Kelly: Affiliation:
Drexel University, Philadelphia

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Summary

Cerebrovascular disease encountered in the emergency department (ED) includes transient ischemic attacks (TIAs) and infarcts (strokes). The purpose of the initial evaluation is to determine whether there is evidence of a stroke, what part of the brain is affected, and whether the patient is a candidate for urgent intervention such as thrombolytic therapy. A chemistry profile, complete blood count (CBC) with platelets, and coagulation profile are essential after completion of brief examination. Attention to adequate airway protection, oxygenation, and circulatory function is essential for management of patients with acute stroke. The use of anticoagulants (heparin or low molecular heparins) remains the most controversial subject in the management of acute stroke. Patients with acute or hemorrhagic strokes need to be admitted to the hospital for further evaluation and management. A neurosurgeon should participate in the care of most patients with intracerebral hemorrhages (ICH) and all patients with subarachnoid hemorrhages (SAH).

Keywords

cerebrovascular disease coagulation heparin infarcts subarachnoid hemorrhage platelets transient ischemic attack intracerebral hemorrhage

Type: Chapter
Information: Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 131 - 145

DOI: https://doi.org/10.1017/CBO9780511547256.013 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2003

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References

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12 - Cerebrovascular Disease

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