CVA-03 · Acute Ischemic Stroke: Imaging, Blood Pressure Management, and Antithrombotics

Acute Ischemic Stroke: Imaging, Blood Pressure Management, and Antithrombotics. Part of the Cerebrovascular / Stroke series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: an established infarct shows up as a dark, hyperdense spot on the CT scan — Correct: A completed/established infarct is HYPOdense (dark) on non-contrast CT. HYPERdense indicates an ACUTE clot (e.g., the hyperdense MCA sign), not an old infarct — the audio conflated the two. (2) In the audio: intensive insulin in the SHINE trial caused high rates of severe hyperglycemia, pushing the blood sugar too low — Correct: The harm from tight/intensive insulin in SHINE was HYPOglycemia (blood sugar too LOW) — the audio's 'pushed it too low' is right, but it should say HYPOglycemia, not hyperglycemia. (3) In the audio: suppress the fever using antibiotics, primarily acetaminophen — Correct: Acetaminophen is an ANTIPYRETIC (fever reducer), not an antibiotic. Post-stroke fever is treated with antipyretics/cooling; antibiotics only address an underlying infection. The written chapter is correct. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/CVA-03.