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System

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DiseaseNeurology

Ischemic Stroke

Recall: Pathophysiology · S/Sx · Gold Standard Dx · First-line Tx · Pearl

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DiseaseNeurology

Pathophysiology: Arterial occlusion (thrombotic or embolic) → focal cerebral ischemia and infarction.
S/Sx: Sudden focal deficit — unilateral weakness, facial droop, aphasia, or neglect (by territory).
Gold Standard Dx: Emergent non-contrast CT head to exclude hemorrhage; MRI is more sensitive for early ischemia.
First-line Tx: IV thrombolysis (alteplase or tenecteplase) within ≤4.5 h if eligible; thrombectomy for large-vessel occlusion; then antiplatelet.

Get a non-contrast CT first — you must rule out hemorrhage before giving tPA.