Comprehensive stroke management: a guide for hospitalists

ABSTRACT

Stroke is a devastating clinical condition characterized by an acute neurological impairment secondary to cerebrovascular disease. Globally stroke is the second leading cause of mortality and disability, with prominent risk factors including age, hypertension, hyperlipidemia, atrial fibrillation, diabetes, smoking, preexisting vascular anomalies and obesity. Acute neurological deficits are commonly encountered in the inpatient wards. Heightened clinical suspicion and prompt evaluation involving neurological examination and imaging is crucial for effective management. At many hospitals, hospitalists are tasked with managing stroke patients with consultation from neurologists. The management of stroke is constantly evolving as new and advanced therapies emerge. This review of the literature seeks to summarize current practice in stroke management in hopes it is helpful to those hospitalists who care for this patient population frequently. A search of the literature was performed to summarize current research as well as management and therapeutic strategies.

KEYWORDS:

• Acute stroke
• ischemic stroke
• cardioembolic stroke
• hemorrhagic stroke
• thrombolytic therapy
• mechanical thrombectomy

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Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

None stated.

Author contributions

Erin Carnish - editing and writing; Ese Kevu - editing and writing.

Table 1. CHA₂DS₂-VASc score for atrial fibrillation

Table 2. CHA₂DS₂-VASc score for atrial fibrillation and its implication in terms of chronic management [34].

Table 3. Ischemic Stroke vs Hemorrhagic Stroke

Additional information

Funding

This paper was not funded.