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Thrombolysis for Ischemic Stroke

Mathias Kalkum listen at doc-kalkum.de
Mon Apr 17 20:46:16 BST 2006


Mike,

> I should've been more specific; the stroke occurred during c-spine manipulation. Would it be most prudent in that case to actually call the internist, or would thrombolysis on the spot be the best alternative for the patient? 

well, now we have a case - and no need to be sorry.

Though I am still missing some details (why manipulation of c-spine? Due 
to trauma, manipulation?) see my comments to Sal.


Sal, yes, such things happen. In my view there is no general rule, one 
has to treat what is worst and has to consider both sides: is immediate 
operative care *necessary* or can be delayed without endangering the 
patient further, location of vessel lesion, size of ischaemic area, kind 
of available treatment options for example.

Cheers

Mathias
(who turns the list into nomail mode for some days after almost a week 
on call)


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