Reperfusion Therapy, Cerebral
Reperfusion Therapy, Cerebral is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- An ischemic cerebrovascular accident (CVA), or stroke, is an acute, sudden or gradual, interruption of regional cerebral blood supply
- Cerebral reperfusion therapy involves:
- Administration of an IV thrombolytic agent to rapidly dissolve a thromboembolic occlusion
- Site-specific endovascular intra-arterial thrombolysis
- Mechanical clot removal
Etiology
Etiology
- Thrombotic CVA is from an in situ thrombosis:
- At an ulcerated atherosclerotic plaque or other prothrombotic endothelial abnormality
- From hypercoagulable states:
- Antithrombin III, protein C or S deficiency
- From sludging:
- Sickle cell disease
- Polycythemia vera
- Embolic CVA is caused by acute obstruction by an embolus from:
- Cardiac mural thrombus formed in:
- Atrial fibrillation
- Hypokinetic ventricle (MI, cardiomyopathy)
- Ventricular aneurysm
- An abnormal or prosthetic cardiac valve
- Aortic, carotid, or cerebrovascular atherosclerotic plaques
- Cardiac mural thrombus formed in:
- Other occlusive events include:
- Vascular dissection in aorta, cerebral, vertebral, carotid, or innominate arteries
- Cerebral vasospasm induced by:
- Subarachnoid hemorrhage (SAH)
- Vasoconstrictive agents (e.g., cocaine)
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Citation
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TY - ELEC
T1 - Reperfusion Therapy, Cerebral
ID - 307259
ED - Barkin,Adam Z,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Shayne,Philip,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307259/all/Reperfusion_Therapy__Cerebral
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -