Stroke in evolution
Stroke in evolution refers to a neurologic deficit that progresses or fluctuates whilst the patient is under observation. Generally, there is no good evidence that intervention is efficacious.
It is rational to heparinise the patient if an ischaemic stroke is evolving, especially if the vertebrobasilar system is involved.
Principles of management :
- maintain blood pressure
- ensure adequate hydration
- control hyperglycaemia
- if evolving and no blood on CT - give 5,000 units heparin followed by 700-1000 hourly
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