| Anesthesia considerations for the patient with acute ischemic stroke. | |
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MedLine Citation:
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PMID: 20472630 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Stroke is the leading cause of long-term disability in the United States. Hence immediate diagnosis must be made by CT or MRI and therapy instituted rapidly. Anesthesiologists must be aware of the concept of "penumbra" and maintain collateral flow. Blood pressure management is crucial. American Stroke Council recommends blood pressure reduction if systolic >220 mm Hg and diastolic >120 mm Hg. However if thrombolytic therapy is being used, blood pressure must be reduced to systolic <180 mmHg and diastolic < 105 mm Hg. Cerebral autoregulation may be dysfunctional in ischemic brain. Anesthesia management requires control of the airway to prevent aspiration, maintain adequate oxygenation and ventilation, and management of raised intra cranial pressure. Complications of intra-arterial thrombolysis include intracerebral hemorrhage. Frequent neurological exams are warranted. Extensive cerebral swelling may require hemi craniectomy. "Time is Brain" hence urgent thrombolysis is the key to a good outcome. |
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Authors:
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Shaheen Shaikh |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Seminars in cardiothoracic and vascular anesthesia Volume: 14 ISSN: 1940-5596 ISO Abbreviation: Semin Cardiothorac Vasc Anesth Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-05-17 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9807630 Medline TA: Semin Cardiothorac Vasc Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 62-3 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, UMass Memorial Hospital, Worcester, MA 01655, USA. shaheen.shaikh@umassmemorial.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia
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methods* Blood Pressure Brain Ischemia / diagnosis, therapy* Cerebral Hemorrhage / etiology Fibrinolytic Agents / administration & dosage, adverse effects, therapeutic use Homeostasis Humans Stroke / diagnosis, therapy* Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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