This course covers the most recent advances in diagnostic tests that are most appropriate for diagnosis of carotid and vertebral artery dissections and imaging necessary prior to treating acute ischemic stroke with IV tPA or mechanical thrombectomy; and providing optimal management before and after treatment. Includes 8 AMA PRA Category 1 Credits™.
Includes 8 AMA PRA Category 1 Credits™. CME expires 12/15/2023.
Chapter 1: Acute Ischemic Stroke: Emergency Department Management After the 3-Hour Window
Acute ischemic stroke is a leading cause of morbidity and mortality in the United States, and a majority of acute ischemic stroke patients are evaluated for the first time by a clinician in the emergency department. Intravenous tissue plasminogen activator and mechanical thrombectomy are powerful tools for the treatment of acute ischemic stroke. Treatment algorithms for acute ischemic stroke are evolving rapidly, and strokes in select patients can now be treated up to 24 hours after last known well time. However, even in the setting of extended treatment times, the treatment effects of both intravenous tissue plasminogen activator and mechanical thrombectomy are time dependent. The emergency clinician must remain current with the newest treatment algorithms in order to provide expeditious and high-quality care to stroke patients.
CME Credits: 4
Chapter 2: Blunt Cerebrovascular Injuries: Early Recognition and Stroke Prevention in the Emergency Department
Blunt cerebrovascular injuries include cervical carotid dissections and vertebral artery dissections that are due to blunt trauma. Although the overall incidence is low, dissections remain a common cause of stroke in children, young adults, and trauma patients. Symptoms of dissection, such as headache, neck pain, and dizziness, are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient or may not be recognized as being due to a dissection. A missed diagnosis of cervical artery dissection can result in devastating neurologic sequelae, and emergency clinicians must act quickly to recognize this diagnosis and begin treatment as soon as possible. This supplement reviews the application of advanced screening criteria, imaging options, and antithrombotic treatment for patients with blunt cerebrovascular injuries, with a focus on reducing the occurrence of ischemic stroke.
CME Credits: 4
Publication Date: September 20, 2022
CME Expiration Date: December 15, 2023