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Acute Ischemic Stroke - Early Management

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Key Points Î The chain of events favoring good functional outcome from an acute ischemic stroke begins with the recognition of stroke when it occurs. Î Data show that the public's knowledge of stroke warning signs remains poor. Î In one study, fewer than half of 9-1-1 calls for stroke events were made within one hour of symptom onset, and fewer than half of those callers thought stroke was the cause of their symptoms. Î Many studies have demonstrated that intense and ongoing public education about the signs and symptoms of stroke improves stroke recognition. Î The California Acute Stroke Pilot Registry (CASPR) reported that the expected overall rate of fibrinolytic treatment within 3 hours could be increased from 4.3% to 28.6% if all patients arrived early after onset. Î Public education campaigns feature one of two stroke recognition tools: • The 5 "Suddens" ▶ Sudden weakness ▶ Sudden speech difficulty ▶ Sudden visual loss ▶ Sudden dizziness ▶ Sudden, severe headache • FAST (Face, Arm, Speech, Time) ▶ One or more of face weakness, arm weakness, and speech difficulty symptoms are present in 88% of all strokes and transient ischemic attacks (TIAs).

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