This is the second edition of a succinct, evidence-based source of answers to questions commonly asked by general practitioners about stroke (eg. definitions, epidemiology, causes, clinical features, investigations, management, outcome and secondary prevention). It is divided into sixteen chapters, each with a list of relevant key references for further reading. The first two chapters define what is meant by a stroke and the size of a problem for stroke patients, their carers and the community. Chapters 3-15 address, in turn, the five key questions that should be answered in the diagnosis and management of all stroke patients: Is it a stroke? Where is the stroke lesion? (i.e. which part of the brain and what arterial territory is affected?) (chapter 4). What is the cause of the stroke? (i.e. is it an infarct or haemorrhage, and what is the cause of the infarct or haemorrhage?) (chapters 6-8). What is the prognosis for survival and handicap? (chapter 9). What can be done to optimise patient outcome and prevent recurrant stroke? (chapters 10-15). Chapter 16 discusses stroke in special populations (e.g. children, pregnant women).
The book concludes with appendices providing information on stroke organisations (including postal and internet addresses) and medical websites.
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How to use this book 1. Terminology and definitions (what is a stroke?) Patient questions 2. Epidemiology how big is the problem of a stroke?) 3. Diagnosis of stroke and transcient ischaemic attack (is it a vascular event?) Symptoms and signs Diagnosis of transcient ischaemic attack diagnosis of stroke Subarachnoid haemorrage Patient questions 4. Localisation of the lesion (where is the damage?) Carotid and vertebrobasilar territory ischaemia Stroke syndromes Boundary zone infarctions 5. Pathological diagnosis Patient questions 6. Aetiological diagnosis 1 (what are the possible causes?) Establishing the cause of stroke Atherosclerosis as a cause of ischaemic stroke Intracranial small vessel disease as a cause of stroke Embolism from the heart as a cause of stroke Rarer causes of ischaemic stroke Establishing the cause of brain haemorrhage Patient questions 7. Aetiological diagnosis 2 (what are the possible risk factors?) General risk factors Cardiovascular risk factors Metabolic risk factors Hormonal risk factors Lifestyle risk factors genetic risk factors Patient questions 8. Aetiological diagnosis 3(what investigations are needed?) Imaging Laboratory tests Patient questions 9. Prognosis (what does the future hold for the patient?) Prognosis of stroke Prognosis of TA Prognosis of subarachnoid haemorrhage Patient questions 10. Early management (should patients be referred to hospital?) Patient questions 11. Hospital management The stroke unit The stroke team The work of the stroke team Patient questions 12. General management (what is basic stroke care?) Patient questions 13. Specific management (what therapy for stroke is effective?) Management principles Thrombolysis in acute ischaemic stroke Asprin therapy Anticoagulation therapy Prevention of deep vein thrombosis Other treatments Patient questions 14. Secondary prevention (how can recurrance be prevented?) Reduction of blood pressure Other measures to prevent recurrent stroke Lifestyle modification and diet Antiplatelet therapy Surgical interventions Stroke caused by cardiogenic embolism Selection of patients for thromboprophylaxis Decision-making Patient questions Post-stroke care (how should new problems be managed?) Progress of stroke Complications Deep vein thrombosis and pulmonary embolism Residual handicaps Patient questions Stroke in special populations Appendix A: Volunteer and support groups and websites Appendix B: Diagnostic evaluation of suspected transcient ischaemic attack and stroke References Glossary List of patient questions Index
