Stroke -- Copyright -- Contents -- Contributors -- Series Foreword -- Preface -- 1 Bedside Evaluation of the Acute Stroke Patient -- Introduction -- Is it a stroke? -- Cortical syndromes -- Small vessel (lacunar) syndromes -- Brainstem syndromes -- Stroke versus TIA? -- Stroke mimics -- The history - guessing the age of a stroke and more -- Rapid examination of the acute stroke patient -- Diagnostic data -- The all important head CT -- Laboratory and ancillary studies -- Biomarkers in acute stroke diagnosis? -- The decision to treat -- Conclusion -- Selected bibliography -- 2 Neurovascular Imaging of the Acute Stroke Patient -- Introduction -- Technical considerations -- Noncontrast computed tomography (NCCT) scan -- Computed tomography angiography (CTA) -- Computed tomography perfusion (CTP) -- Diffusion-weighted imaging (DWI) -- Gradient echo (GRE) T2*-weighted imaging -- Magnetic resonance angiography (MRA) -- Magnetic resonance perfusion weighted imaging (MRP) -- Clinical considerations -- Imaging evaluation of acute cerebral ischemia -- Imaging evaluation of acute nontraumatic intracranial hemorrhage -- Conclusion -- Selected bibliography -- 3 Treatment of Acute Ischemic Stroke -- Introduction -- Intravenous thrombolysis -- Key clinical trials -- Optimizing clinical outcomes following intravenous thrombolysis -- Post-thrombolysis care -- Treating complications of rt-PA -- Special patient circumstances -- Endovascular arterial reperfusion -- Key clinical trials of intra-arterial thrombolysis -- Special clinical scenario: acute basilar artery occlusion -- Mechanical thrombectomy -- Postprocedural care -- Decision making -- Future directions -- Selected bibliography -- 4 Diagnosis of Stroke Mechanisms and Secondary Prevention -- Introduction to diagnostic evaluation -- Do the symptoms represent cerebral ischemia (versus nonischemic pathology)?.

Where does the process localize? -- What are the potential etiologies and mechanisms of cerebral infarction and TIA? -- What is the prevalence (pretest probability) of each potential etiology? -- What test modalities exist and what is the sensitivity and specificity of such? -- What are the potential treatment options? -- General approach -- The utility of cross-sectional imaging -- Diagnostic evaluation and treatment by etiology -- Cardioembolic -- Large vessel extracranial -- Large vessel intracranial -- Small vessel disease -- Coagulation disorders -- Risk factors -- Conclusion -- Selected bibliography -- 5 Treatment of Hemorrhagic Stroke -- Intracerebral hemorrhage -- Introduction -- Epidemiology -- Etiology -- Pathophysiology -- Manifestations -- Diagnostic considerations -- Treatment -- Subarachnoid hemorrhage -- Introduction -- Epidemiology -- Etiology -- Pathophysiology -- Clinical manifestations -- Diagnostic considerations -- Treatment -- Conclusion -- Selected bibliography -- 6 Prevention and Management of Poststroke Complications -- Medical complications in stroke patients -- Venous thromboembolism -- Urinary tract complications -- Aspiration pneumonia -- Nonbleeding complications of recombinant tissue plasminogen activator -- Pressure sores and ulceration -- Falls -- Malnutrition -- Pain -- Miscellaneous medical complications -- Cardiac complications -- Gastrointestinal (GI) complications -- Neuropsychiatric disturbances -- Neurological complications in stroke patients -- Cerebral edema -- Hemorrhagic transformation -- Seizures -- Miscellaneous neurological complications -- Headache -- Sleep disorders -- Conclusion -- Selected bibliography -- 7 Poststroke Recovery -- Introduction -- Natural history of stroke recovery -- Phases of stroke: implications for rehabilitation -- Hyperacute phase (<24 hours after stroke onset).

Acute phase (24 hours to 4 weeks after stroke onset) -- Subacute phase (1 month to 3 months after stroke onset) -- Chronic phase (>3 months after stroke onset) -- Mechanisms of stroke recovery -- Emerging technology -- Predicting motor recovery of the upper limb after stroke rehabilitation with emerging technology -- Emerging treatments and technology for stroke rehabilitation -- Summary -- Selected bibliography -- 8 Telemedicine Networks and Remote Evaluation of the Acute Stroke Patient -- Introduction -- Strategies for telestroke network building -- Summary of the evidence supporting telemedicine use in acute stroke diagnosis and management -- Strategies for funding the development of a telestroke network -- Economic sustainability, cost effectiveness, and the status of reimbursement for telestroke -- Fundamentals of telestroke networks -- Implementation of telemedicine within stroke systems of care -- Incorporating evidence-based practice guidelines and care pathways into a telestroke network -- Engaging stakeholders -- Administrative infrastructure -- Telestroke technology options -- Metrics to track performance, outcomes, and quality of a telestroke network -- Telestroke networks -- Overcoming challenges to sustain a telestroke network -- Identifying and overcoming obstacles (licensing, credentialing, privileging, medicolegal, financial, and reimbursement issues) -- Tips and tools for sustaining a telestroke network -- Getting buy-in from referring physicians, administrative leadership, and telemedicine providers -- Telestroke staff education -- Keeping hub and spoke partners engaged -- how to combat telemedicine fatigue -- Conclusion -- Selected bibliography -- 9 Appendix: Practical Clinical Stroke Scales -- Introduction -- Stroke clinical outcome scales -- Clinical risk stratification scores -- Hemorrhagic stroke severity scales.

Eligibility criteria for intravenous rt-PA 0-4.5 hours -- Internet resources -- Index -- Supplemental Images.