CK-12 Biology I - Honors by CK-12 Foundation

By CK-12 Foundation

CK-12 Biology I is a textbook for top university scholars masking phone biology, genetics, evolution, ecology, and body structure.

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3%). However, a much larger randomized trial that included over 2,000 subjects did not find benefit in acutely lowering blood pressure. This trial used candesartan versus placebo in ischemic or hemorrhagic stroke treated within 30 hours of stroke onset. The mean difference in BP was 5/2 mmHg. There was no benefit for early treatment, and in fact, there was a trend toward worse functional outcome. The AHA recommends treatment for SBP over 220 or diastolic blood pressure (DBP) over 120. If treatment is warranted, the blood pressure should be lowered cautiously, 15% to 20% in the first 24 hours.

Stroke. 2003;34:392–396. 10 PRIMARY PREVENTION OF STROKE 47 This page intentionally left blank 11 Asymptomatic Internal Carotid Artery (ICA) Stenosis A 63-year-old man with hypertension, diabetes, high cholesterol, tobacco abuse, and coronary artery disease was referred for evaluation after being found to have internal carotid artery stenosis. He denies every having had a stroke or transient ischemic attack (TIA). He had coronary artery bypass surgery five years ago and had carotid Dopplers at that time.

It is important to recognize malignant MCA syndromes, since there is a very high association with early worsening and death (up to 80%). Predictors of a malignant pattern include high initial NIHSS, usually over 16; younger age (less atrophy and room for swelling); and early signs of edema. The cascade of deterioration is due to edema. Edema is usually maximal in 48 to 72 hours after a stroke. Because the skull is a rigid, confined space, there is little room to accommodate extra mass from brain edema.

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