• "Fall risk" is not always a legitimate reason not to use anticoagulation for stroke prevention in A fib.  One study showed you need to fall about 150 times a year to justify not putting a patient on coumadin due to fall risk.  
  
  

  Posted 05/25/17 02:58:10 PM by Emily Miller

• Use clinical signs as a way to triage the likely size of a CVA, single lobe vs. multilobar.  Gaze deviation = frontal lobe.  Motor weakness = frontal and parietal lobes.  Dysarthria = temporal lobe.  if 3 lobes are involved, stroke will likely be very disabling.   
  
  

  Posted 05/25/17 03:00:27 PM by Emily Miller

• Risk of mass effect and hemorrhagic conversion post CVA peaks at day 2-3.  Don't wait for blown pupil or signs of herniation to suspect.  If patient is sleepy w/ more than 50% cerebral involvement on imaging, they would likely benefit from prophylactic hemicraniotomy (NNT = 2!)
  
  

  Posted 05/25/17 03:02:16 PM by Emily Miller

• Typically wait 2-4 weeks prior to starting anticoagulation for secondary stroke prevention after CVA. 
  
  

  Posted 05/25/17 03:02:50 PM by Emily Miller

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