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ABCD score
0-3 = low
4-5 = moderate
6-7 = high
How does TIA differ from ischemic stroke
TIA symptoms are transient
TIA workup?
MRI preferable
Non cardiogenic:
→Above aortic arch
→Carotid
→Intracranial
ANTIPLATELET
Cardiogenic embolism
Below aortic arch
ANTICOAG
ABCDE
Antiplatelet
Anticoag
Sleep Apnea
Blood pressure
Cholesterol
Cigarettes
Diabetes
Exercise
Antiplatelet (non cardio only)
Aspirin 81 or clopidogrel
DAPT only if NIHSS 3 or less or ABCD 4 or higher
→Start within 1-7 days of stroke or TIA
→21-90 days ASA/Clopidogrel then single AP
→30 days ASA/Ticagrelor
→NIHSS 5 or less, ABCD 6 or higher
Anticoag (cardio)
Anticoag: Cardioemobolic ischemic stroke
1)Afib= DOAC 3 mo
2)Acute MI with LV thrombus = warfarin or DOAC 3 months
3)Dilated cardiomyopathy: Warfarin 3 months
Blood pressure
ACEI, ARB, Thiazide diuretic
Wait like 4 days
Cholesterol goal
LDL <70
Diabetes
HFReF→ SGLT2
Obesity= GLP1
Diet
Reduce by 1 g/day, <2.5 g/day bc hyponatremia mimics stroke symptoms
Can they have alcohol??
NO!