Evidence based strategies in Stroke Management

Most of the time there’s nothing much to do for the ischemic stroke patient but here’s some evidence based strategies that can potentially reduce the morbidity/mortality:

  1. Positioning: Elevation of the head of the bed (HOB) > 30 degrees
  2. Glucose control: 7.7-10 mmol/L (hyperglycemia associated with increased ICP and progression to hemorrhagic conversion)
  3. Blood pressure control: 15% reduction MAP over 24 hours if BP exceeds 220/120 (likely best accomplished with nicardipine infusion to avoid overcorrection)
  4. Adjunctive therapies: Prevent fever and hypercapnea
  5. Early physio and occupational therapy