a.k.a. CVA → cerebrovascular accident

DDx

!Ischemic Stroke → 85%

!ICH - Hemorrhagic Stroke → 15%

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Stroke in younger patients

Stroke Work-up

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Initial Management

BP Management

!Ischemic Stroke target < 220/120 for 24-48 hours
- If planned for lysis- 185/110
- 24 hours post lysis - 180/105
!ICH - Hemorrhagic Stroke(ICH) < 140mm hg
- !SAH - Subarachnoid Hemorrhage - SBP 140-160 mmHg

Post-Op Stroke

Neurologic Complication	Description	Causes / Risk Factors	Presentation	Management
Postoperative Stroke	Acute neurological deficit due to ischemic or hemorrhagic cerebrovascular event	History of stroke/TIA, atherosclerosis, atrial fibrillation, carotid stenosis, perioperative hypotension, hypercoagulable states	Sudden focal neurological deficits (e.g. weakness, aphasia, facial droop); may be subtle post-op	Urgent neuroimaging (CT/MRI), neurology consult, supportive care, manage BP, consider anticoagulation or intervention depending on stroke type and timing

Post-stroke complications

Lance-Adam Syndrome