Emergency Stroke Care: Advances And Controversies, Volume I (Stroke CME)

About This Resource

Emergency Stroke Care: Advances and Controversies, Volume I, summarizes current guidelines and best practices for diagnosis and treatment of acute stroke and transient ischemic attack. Primary topics covered in this edition include:

• IV rtPA Use
• Advanced Acute Stroke Imaging
• Endovascular Therapies
• American Heart Association/American Stroke Association Guidelines
• TIA Diagnosis
• The ABCD2 Score
• Cardiac Evaluation in TIA
• Echocardiography, CT, and MRI
• Current Therapies: Antiplatelet Agents, Anticoagulants, Thrombolysis, and Risk Factor Control

Product Details

Publication Date: March 1, 2016

CME Expiration Date: March 1, 2019

CME: This enduring material includes 8 AMA PRA Category 1 CreditsTM. (Stroke CME)

Editor

Andy Jagoda, MD 
Professor and Chair, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai; Medical Director, Mount Sinai Hospital, New York, NY

Authors

R. Jason Thurman, MD, FAAEM, CPPS
Chief Medical Officer, TriStar Skyline and Hendersonville Hospitals, Nashville, TN; Adjunct Associate Professor of Nursing, Vanderbilt University Medical Center, Nashville, TN

Edward C. Jauch, MD, MS
Professor, Division Director, Emergency Medicine, Vice Chair of Research, Department of Medicine, Professor, Department of Neurosciences, Medical University of South Carolina, Charleston, SC

J Mocco, MD
Professor, Department of Neurosurgery, Mount Sinai Health System, New York, NY

Reade De Leacy, MD, FRANZCR
Assistant Professor, Department of Neurosurgery and Radiology, Cerebrovascular Center, Mount Sinai Health System, New York, NY

Thomas James Oxley, MD
Fellow, Department of Neurosurgery, Mount Sinai Health System, New York, NY

Christopher Paul Kellner, MD
Fellow, Department of Neurosurgery, Mount Sinai Health System, New York, NY

Peter D. Panagos, MD
Assistant Professor of Emergency Medicine and Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO

Matthew S. Siket, MD, MS
Assistant Professor of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI

Laura Heitsch, MD
Assistant Professor of Emergency Medicine and Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO

Jonathan A. Edlow, MD
Professor of Emergency Medicine, Harvard Medical School; Vice Chair of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA

Table of Contents

Chapter 1: Transient Ischemic Attack: An Evidence-Based Update On Diagnosis And Management

1. Abstract
2. Case Presentations
3. Introduction
4. Selected Abbreviations
5. Critical Appraisal Of The Literature
6. Definition
7. Epidemiology
8. Etiology And Pathophysiology
9. Differential Diagnosis
10. Prehospital Care
11. Emergency Department Evaluation
    1. History
    2. Physical Examination
    3. Risk Stratification
12. Diagnostic Studies
    1. Laboratory Testing
    2. Cardiac Evaluation
    3. Brain Imaging
    4. Vascular Imaging
    5. Perfusion Imaging
13. Management
    1. Antihypertensive Treatment
    2. Antiplatelet Therapy
    3. Aspirin
    4. Other Antiplatelet Agents And Combinations
    5. Anticoagulation
    6. Management Of Large-Artery Atherosclerosis
    7. Lifestyle Modifications And Risk Factor Control
    8. Thrombolysis
    9. Disposition
14. Risk Management Pitfalls For Transient Ischemic Attack
15. Case Conclusions
16. Time- And Cost-Effective Strategies
17. Selected Abbreviations
18. References
19. CME Questions

Chapter 2: Evolving Strategies In The Emergent Treatment Of Acute Ischemic Stroke

1. Abstract
2. Case Presentations
3. Introduction
4. Abbreviations
5. Critical Review Of The Literature
6. Pathophysiology
7. Section I: Expanding Opportunities For Intravenous Recombinant Tissue Plasminogen Activator Use In Acute Stroke
   1. Extending The Time Window
   2. Minor Stroke Symptoms
   3. Rapidly Improving Stroke Symptoms
   4. Relative Contraindications To Intravenous rtPA
   5. Summary: Extended rtPA Window
8. Section II: Advanced Acute Stroke Imaging
   1. Multimodality Computer Tomography
   2. Noncontrast Computed Tomography
   3. CT Angiography Of The Head And Neck
   4. CT Perfusion, 4-Dimensional CT Angiography, And Multiphase CT Angiography
   5. Evolution Of “Time Is Brain” To Include “Physiology Is Brain”
   6. Concerns And Potential Limitations Of Multimodality Neuroimaging
   7. Summary: Multimodality Neuroimaging In Acute Stroke
9. Clinical Pathway For Management Of Acute Ischemic Stroke In The Emergency Department
10. Section III: Update On Endovascular Therapies For Acute Ischemic Stroke
    1. Angioplasty And Cervico-Cerebral Stenting
       1. New Devices
    2. A Major Paradigm Shift: Mechanical Thrombectomy With Stentriever
    3. Summary: The Future Of Stroke Revascularization Therapy
11. Section IV: Stroke Systems Of Care
    1. Background And Significance
    2. Acute Stroke-Ready Hospitals
    3. Primary Stroke Centers
    4. Comprehensive Stroke Centers
    5. Stroke Systems Of Care
    6. Evidence-Based Outcome Measures
    7. Summary: Stroke Systems Of Care
12. Conclusion
13. Risk Management Pitfalls For Acute Ischemic Stroke
14. Case Conclusions
15. Abbreviations
16. References
17. CME Questions