Stroke (SCTID: 230690007)

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Stroke (SCTID: 230690007) by Mind Map: Stroke (SCTID: 230690007)

1. Investigations

1.1. Non-contrast CT scan of brain (SCTID: 396205005)

1.1.1. Intracranial haemorrhage (SCTID: 1386000)

1.1.2. Brain tumour (SCTID: 254935002)

1.1.3. Ischaemic stroke (SCTID: 422504002)

1.1.4. Normal (SCTID: 408568004)

1.1.5. Other diagnosis

1.2. Glucose level (SCTID: 365811003)

1.2.1. <2.8 mmol/L or >22 mmol/L

1.2.2. 2.8 mmol/L to 22 mmol/L

1.3. CT angiogram of head and neck (SCTID: 710073000)

1.3.1. Occlusion of internal carotid artery, or section A1-A2 of the anterior cerebral artery, or section M1-M2 or middle cerebral artery

2. Clinical findings (SCTID: 404684003)

2.1. Signs (SCTID: 72670004)

2.1.1. National Institute of Health Stroke Scale (NIHSS) (SCTID: 450741005)

2.1.1.1. Level of consciousness

2.1.1.2. Horizontal eye movements

2.1.1.3. Visual fields

2.1.1.4. Arm weakness

2.1.1.5. Leg weakness

2.1.1.6. Facial weakness

2.1.1.7. Slurred speech

2.1.1.8. Ataxia

2.1.1.9. Sensation

2.1.1.10. Aphasia

2.1.1.11. Inattention

2.1.1.12. NIHSS score

2.1.2. Weight (SCTID: 162763007)

2.2. Timing (SCTID: 272103003)

2.2.1. Onset (SCTID: 217315002)

2.2.1.1. Sudden onset (SCTID: 385315009)

2.2.1.2. Gradual onset (SCTID: 61751001)

2.2.2. Duration (SCTID: 272116003)

2.2.2.1. >4.5 hours

2.2.2.2. <4.5 hours

3. Treatment

3.1. Alteplase (SCTID: 27638005)

3.1.1. Dose (SCTID: 408102007)

3.1.1.1. Bolus

3.1.1.2. Infusion

3.1.2. Indications (SCTID: 410665000)

3.1.2.1. Ischaemic stroke (SCTID: 422504002)

3.1.2.2. Time of onset <4.5 hours

3.1.2.3. Age (SCTID: 424144002)

3.1.2.3.1. >18 years-old

3.1.2.3.2. <18 years-old

3.1.3. Medical contraindications (SCTID: 397745006)

3.1.3.1. Intracranial haemorrhage (SCTID: 1386000)

3.1.3.2. Clinical suspicion of subarachnoid haemorrhage

3.1.3.3. Neurologic surgery, serious head trauma, or previous stroke in past 3 months

3.1.3.4. Uncontrolled hypertension (>185 mmHg SBP or >110 mmHg DBP)

3.1.3.5. History of intracranial hemorrhage

3.1.3.6. Seizure at stroke onset

3.1.3.7. Known arteriovenous malformation, neoplasm, or aneurysm

3.1.3.8. Active internal bleeding

3.1.3.9. Known bleeding diathesis

3.1.3.10. Abnormal blood glucose

3.2. Clot retrieval (SCTID: 240918000)

3.2.1. Indications (SCTID: 410665000)

3.2.1.1. Time of onset <6 hours

3.2.1.2. Age >18

3.2.1.3. CT angiogram showing occlusion of internal carotid artery, or A1-A2 of the anterior cerebral artery, or M1-M2 or middle cerebral artery

3.2.2. Surgical contraindications (SCTID: 397773008)

4. Diagnosis (SCTID: 439401001)

4.1. Ischaemic stroke (SCTID: 422504002)

4.2. Intracranial haemorrhage  (SCTID: 1386000)

4.3. Other diagnosis

5. Prognosis (SCTID: 365858006)

5.1. Good (SCTID: 170968001)

5.2. Fair (SCTID: 65872000)

5.3. Bad (SCTID: 170969009)