Accidente cerebrovascular ACV Isquémico 2025: Código Ictus, Trombolisis | USAMEDIC

🧠 ISCHEMIC STROKE: DIAGNOSIS AND URGENT MANAGEMENT UPDATED 2025 In this educational video, we comprehensively address ischemic stroke with the latest 2025 updates, from early recognition to the stroke code, Cincinnati Stroke Scale, NIHSS, therapeutic window, thrombolysis with alteplase, mechanical thrombectomy, secondary prevention, and neurological rehabilitation. 📋 VIDEO CONTENT: Definition and epidemiology of ischemic stroke Pathophysiology: arterial occlusion and ischemic penumbra Risk factors: hypertension, atrial fibrillation, diabetes, smoking TOAST classification: atherothrombotic, cardioembolic, lacunar Recognition: Cincinnati Stroke Scale (FAST) Stroke code: urgent activation NIHSS score (0-42 points) Therapeutic window: less than 4.5 hours for thrombolysis Neuroimaging: non-contrast CT, diffusion-weighted MRI IV thrombolysis with alteplase (rtPA) Mechanical thrombectomy: up to 24 hours Inclusion and exclusion criteria Management in the stroke unit Secondary prevention: antiplatelet therapy, anticoagulation Complications: hemorrhagic transformation, cerebral edema Early neurological rehabilitation 🎯 TARGET AUDIENCE: Neurologists and residents Neurology Emergency and Urgent Care Physicians Intensivists and Neurocritical Care Physicians Internal Medicine Physicians Interventional Radiologists Primary Care Physicians Paramedics and Emergency Medical Technicians Medical Residents Medical Resident Candidates Medical Students Emergency and ICU Nurses ⚕️ KEY POINTS: ✅ Ischemic stroke: neurological emergency (time is brain) ✅ Cincinnati/FAST Scale: rapid detection (face, arms, speech) ✅ Stroke Code: immediate activation within 4.5 hours ✅ Non-contrast brain CT scan: rule out hemorrhage ✅ IV thrombolysis: alteplase 0.9 mg/kg (window less than 4.5 hours) ✅ Mechanical thrombectomy: occlusion of large vessels (up to 24 hours) ✅ Secondary prevention: aspirin, statins, risk factor management 📚 TOPICS SPECIFIC: PATHOPHYSIOLOGY: Arterial occlusion (thrombus, embolus) Cerebral ischemia Infarcted nucleus (neuronal death) Ischemic penumbra (salvageable tissue) "Time is brain": 1.9 million neurons/minute TOAST CLASSIFICATION: Atherothrombotic (large vessels) Cardioembolic (atrial fibrillation, valvular heart disease) Lacunar (small vessels) Other causes (dissection, vasculitis) Undetermined VASCULAR TERRITORIES: Anterior cerebral artery (ACA) Middle cerebral artery (MCA) - most common Posterior cerebral artery (PCA) Posterior circulation (vertebrobasilar) STROKE CODE: Prehospital activation Cincinnati/FAST score Urgent transfer to stroke center Door-to-needle time less than 60 seconds min Door-to-puncture time less than 90 min NIHSS SCALE: 0-42 points Evaluates: consciousness, gaze, visual fields, facial paresis, arm/leg motor function, ataxia, sensation, speech, dysarthria, neglect NEUROIMAGING: Non-contrast CT scan: to rule out hemorrhage Early signs: MCA hyperdensity, loss of gray-white matter differentiation Diffusion-weighted MRI: detects early ischemia CTA: to evaluate for large vessel occlusion 🔗 USEFUL LINKS: Subscribe for more updated medical content Turn on notifications 🔔 Share with colleagues and fellow residents Comment with your questions and clinical cases Like if you found the content helpful #️⃣ HASHTAGS: #IschemicStroke #Stroke #VILLAMEDIC #MedicalResidency #Neurology #CerebrovascularAccident #CodigoIctus #Thrombolysis #Thrombectomy #EscalaCincinnati #FAST #NIHSS #Alteplase #rtPA #EmergenciaNeurologica #TiempoEsCerebro #VentanaTerapeutica #UnidadIctus #StrokeUnit #IschemiaCerebral #InfartoCerebral #OclusionArterial #PenumbraIsquemica #TACCerebral #RMDifusion #Angiotomy #Aphasia #Dysarthria #Neglect #HemorrhagicTransformation #CerebralEdema #BrainHerniation #Craniectomy #NeurologicalRehabilitation #NeurologicalPhysiotherapy #OccupationalTherapy #SpeechTherapy #StrokeRecovery #InternalMedicine #ClinicalNeurology #MedicalEmergency #IntensiveCare #NeurocriticalCare #NeurologicalEmergencies #MedicalEducation #Healthcare #MedicalStudent #GeneralPractitioner #MedicalResident #ENAM #ENARM #Medicine #MedicalSciences #HealthEducation #MedicalEducation #DoctorLife #MedicineLife #MedStudentLife #Neurology #IschemicStroke #StrokeCode #Thrombolysis #Update2025 #Guidelines2025 #Neurology2025