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Internal Medicine
2) Reversible Ischemic neurologic deficit: sudden onset focal neurologic deficit which
lasts for more than 24 hours, but the neurologic deficit recovers / resolves /.
3) Stroke in evolution: a focal neurologic deficit, the degree of which is progressing over
a couple of hours or days.
4) Complete stroke: sudden onset of focal neurologic deficit, in which the deficit neither
improves nor gets worse over time. It is often associated with infarction of part of the
Epidemiology and risk factor
Stroke is prevalent all over the worldwide. It is third commonest cause of death in developed
world following Coronary heart diseases and cancer. It is a leading cause of disability.
The prevalence and incidence of stroke is also on the rise in developing countries.
Major risk factors associated with stroke include
Incidence is higher in men and old age
Diabetic mellitus
Atrial fibrillation
Myocardial infarction
Congestive heart failure
Acute alcohol abuse
Approach to a patient with stroke:
Goals /Steps
1. Assessment and maintenance of vital functions
2. Determination of presumptive diagnosis of stroke subtype
3. Confirmation of stroke subtype
4. Management of a patients with stroke
1. Initial Assessment and maintenance of vital functions/stabilizing the patient
Stroke should be considered as medical emergency, as it affects vital functions of an individual.
For this reason the initial step in management of patients with acute stroke should be rapid
assessment and maintenance of vital functions. This includes: