What are the indications for immediate neurosurgical evaluation in patients with intracerebral hemorrhage?
Neurosurgical evaluation is required in patients with: 1. 1. Large clots in the frontal, temporal or occipital regions with progressive clinical deterioration. 2. 2. Deep basal ganglia clot in the non-dominant hemisphere with progressive deficit. 3. 3. Acute cerebellar hematoma larger than 3cm, indicating the need for operative intervention. What are summary pearls regarding the adjuncts in the ED management of acute ischemic stroke patients? . • In general, aspirin should be avoided until after CT confirmation that the stroke is non-hemorrhagic, and that tPA is not indicated for the patient. . • BP management should be guided by the need to avoid both marked hypertension and hypotension. . • Early ischemic changes on CT assist in decision-making by suggesting the appropriateness of tPA use, based on the likely stroke onset time and the size of the involved cerebral cortex. . • Heparin has no role (other than DVT prophylaxis) in acute ischemic stroke. . • Glucose management should atte
