starting on stroke service

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CD4TH2

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Looks like my very first rotation as an intern / PGY1 will actually be with neurology on the stroke team.
Any advice from current residents? thanks guys
 
Depends on the program and structure of the program, but just go through neuro exam, vascular anatomy and basic localization methodology to start with.Be familiar with the various etiologies of AIS ( TOAST classification is the short one). You can read about recent trials and evidence based indications/contraindications of anti platelets, anticoagulation(warfarin and NOAC) , statins, thrombolysis and mechanical thrombectomy. You can also update urself about current evidence for management of Diabetes, HTN, HLD, afib. And depending on ur program- Mx of Critical care stuff esp malignant strokes/ ICH and elevated ICP.
 
agree w/ the above.

stroke (neurology in general, actually) is a very research heavy field at this time, and new data is constantly being poured out regarding treatment options. i would try to stay up to date with this.
 
thanks guys really appreciate the advice
 
Any good stroke textbooks for neuro residents? Already did a Google search of this forum and just found general neuro books....
 
There are stroke texts, but they tend to deal in principles, because the management changes with current research and the books can never keep up with that. So you're better off finding some good reviews of current topics in vascular neurology and letting them sum-up the literature for you. Acute stroke management can be covered by the AHA guideline and more recent supplement, endovascular treatment there are a million reviews of the current data, antithrombotics and lipid management in secondary prevention is the same. There are reviews of the literature for management of symptomatic and asymptomatic carotid disease, as well as intracranial athero. For ICH, there are a bunch of reviews that deal with location-specificity of etiopathology, as well as CAA specifically and the issues with using antiplatelets, statins, and anticoagulation in that population. The literature on the CCS classification system sums up the prior literature on ischemic stroke classification well, which is important if you want to assign an etiology and plan secondary prevention.

Read a few of those and you'll be better off pragmatically than most texts will be able to prepare you, although the classics are always important from a knowledge base perspective.
 
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