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Emergency Examination
and Treatment for TIA or Stroke
What You Should Know |
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Your doctor in the emergency department believes that you may be having a TIA (transient ischemic attack) or a stroke. These conditions occur when the blood flow to your brain is blocked and your brain does not get enough oxygen.
There are several types of strokes, and each type has several treatment options. To give you the best possible care, your doctor will work with a team of caregivers, who may do repeated examinations and order routine studies such as blood tests and x-rays. Additional tests may be ordered to determine the best treatment option for you.
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What ADDITIONAL tests are used to diagnose a TIA or stroke? |
Neurological Examination – Doctors will perform an exam to see if you can walk, talk, reach with your arms, see clearly, and feel touch on your skin. This will show how well your brain is sending signals to your muscles and nerves.
CT Scan – Also called a CAT scan, this is a series of computerized x-rays that take pictures of the brain or other parts of the body in thin slices. Before the CT scan is performed, a dye may be injected through your vein.
MRI – Magnetic resonance imaging requires that you lie still while the machine takes very detailed pictures of your brain and blood vessels from different angles.
Carotid Ultrasound – This test uses ultrasound waves to show the blood flow in the arteries in your neck that carry blood to the brain. These are called the carotid arteries. By checking the speed of blood flow and the shape of the carotid arteries, this test can detect narrowing or blockage of the arteries.
Arteriography – This test, also called angiography, is an x-ray test using a special dye to see the arteries better. A radiologist will insert a long, thin tube called a catheter into a blood vessel in your groin area and advance it through your blood vessels toward your brain. (The area will be numbed before the doctor inserts the catheter.) Then the dye will be injected through the catheter so the vessels – such as the carotid arteries and arteries in the brain – can be seen. This test helps doctors find a blocked or narrowed blood vessel.
Echocardiogram – Also called an echo, this test uses ultrasound waves to show a moving picture of the size and shape of the heart and the heart valves, and to see how the heart moves as it beats. After a clear jelly is applied, a sensor is rubbed across the chest so doctors can see the heart from different angles.
Swallowing function test – A doctor or nurse may test your ability to swallow safely before giving you anything to eat or drink, including medications. A stroke sometimes causes swallowing problems that could increase the risk of pneumonia.
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How is a TIA or stroke treated? |
Oxygen – When needed to help you breathe more easily, you may be given oxygen through a plastic mask or through a plastic tube that fits under you nose (nasal cannula).
Intravenous Access – A needle may be inserted into a vein to make it easier to give medications. This access to your veins is called an IV.
Tissue Plasminogen Activator (tPA) – This medication is used to dissolve blood clots and can be given intravenously only within 3 hours of the start of symptoms. Although appropriately selected patients may benefit from treatment with tPA, it is not without risk. Some people experience bleeding complications, including bleeding into the brain, which can be life threatening.
Antiplatelets – Platelets in the blood have a normal function of helping to form clots to stop bleeding, such as when you have a cut. But with a stroke, clots need to be prevented, so antiplatelet medications may be given to keep the blood flowing. The most commonly used antiplatelet agents are aspirin, clopidogrel bisulfate (Plavix), and aspirin/dipyridamole (Aggrenox). Before antiplatelets are given, your doctor will ask you for information about conditions that might increase your risk of bleeding.
Surgery or Endovascular Treatment – In some cases, surgery on the carotid artery in the neck or a procedure that uses catheters within the blood vessels may be required to remove the blood clot directly from an artery.
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Participate in your care |
As your medical team reviews the information from your tests, they will determine what treatment, or combination of treatments, is best for the type of TIA or stroke you have experienced.
You should discuss all treatment options with your medical team. You need to understand what each test and treatment means for your condition and what the risks and benefits are for each of the proposed treatments. Take the opportunity to ask questions. You may be asked to sign consent forms, or someone who has permission can sign for you. |
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WALK (Is their balance off?)
TALK (Is their speech slurred or face droopy?)
REACH (Is one side weak or numb?)
SEE (Is their vision all or partly lost?)
FEEL (Is their headache severe?)
If any of these stroke symptoms occur suddenly call 9-1-1! |
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