Neurology Stroke for UPSC CMS: Types, FAST Recognition, tPA Window and Management

FAST Recognition#

Face: Drooping on one side
Arm: Weakness/numbness in one arm
Speech: Slurred, confused
Time: Call emergency immediately

Ischemic Stroke#

85% of strokes. Types: Atherothrombotic, Lacunar, Cardioembolic (AF). Treatment: tPA (0.9 mg/kg, max 90mg) if within 4.5 hours. Mechanical thrombectomy up to 24 hours for large vessel.

Hemorrhagic Stroke#

15%. BP control (target <140 mmHg), Neurosurgical consultation, lower ICP (mannitol, hyperventilation). Poor prognosis.

Secondary Prevention#

Antiplatelet: Aspirin (150-300mg daily), or Aspirin + Dypiridamole. Anticoagulant if AF (DOAC preferred over warfarin). Statin. BP control.