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Stroke

Stroke. Ruth Derham Tuesday 4 th February. What We Will Cover. Case Learning Points GP management. Presentation. 78 year old gentleman 1/52 history of ‘not right’, unsteady on feet Why today? (Why A and E??) – first time seen anyone. Examination. Cardiorespiratory – normal

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Stroke

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  1. Stroke Ruth Derham Tuesday 4th February

  2. What We Will Cover... • Case • Learning Points • GP management

  3. Presentation • 78 year old gentleman • 1/52 history of ‘not right’, unsteady on feet • Why today? (Why A and E??) – first time seen anyone

  4. Examination • Cardiorespiratory – normal • Abdomen – normal • Cranial nerves – normal • Neuro – grossly intact EXCEPT ataxic gait, dysdiadochokinesis and hypermetria left hand

  5. Investigations • Blood tests • Urinalysis • CXR • CT Brain

  6. Outcome

  7. Outcome

  8. Outcome • Malignant melanoma excised 3 years ago • Discharged from ward 5 • Re-admitted 9th January with collapse • Died in hospital

  9. Learning Points • Why are they presenting now? • Take relatives seriously • Use all of the information available...

  10. What can GPs do about stroke/TIA? • Do not necessarily need to go to ED • Stroke mobile • TIA referral

  11. Proforma

  12. NICE CG68 (Acute Stroke and TIA) • http://www.nice.org.uk/nicemedia/live/12018/41316/41316.pdf • Aspirin 300mg daily • ?statins “individual risk factors” • ABCD2

  13. Summary • Case • Learning Points • GP management

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