This is Steve Carroll for the Am Basic podcast.

Today we're going to talk about stroke and transient ischemic attack, or TIA.

In the ED, we are the front line in dealing with stroke in TIA,

and we need to get it right so our patients can avoid lifelong disability.

Today we'll talk about how to recognize stroke,

the actions that we need to take in the first few minutes of the

patient's arrival, how to make sure we don't miss any other disease processes, and how to treat

our patients with stroke and TIA. As always, this podcast doesn't represent the views or opinions

of the Department of Defense, the U.S. Army, or the Shawshack EM Residency Program. Before we start

talking about the patient presentation, let's talk a little bit about the

definition of stroke and TIA.

It is important to note that a stroke can be caused by two different processes.

Strokes can be divided into either ischemic or hemorrhagic.

An eczemic stroke is caused by an acute clot in a cerebral artery.

A hemorrhagic stroke is caused by a leaking blood vessel with resulting bleeding into the brain.

Let's talk about an ischemic stroke first.

We call this an eczemic stroke because it is cutting off blood and oxygen supplied to brain tissue.

When we are talking about an acute clot, we were referring to an actual blood clot that is formed

in the artery, or a clot that has been formed elsewhere and embolized to the brain.

An example of this would be a patient with atrial fibrillation who has developed a clot in

the left atrium that breaks off and goes to the brain.

You can also have septic emboli from an infected heart valve that showers into the brain, although that is much more rare situation.

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