I used the analogy 'cerebral unstable angina' to suggest the similar
pathophysiology that exists between cerebral and cardiovascular disease.
Think of it as an 'ulcerated' plaque of scarred lipid sat on the main blood
vessel to a brain!
There also exists a similar range of treatments.
The problem.
'Cardiac angina' Treatment = Aspirin + Heparin = Little Harm = BIG
BENEFITS!
'Cerebral angina' Treatment = Aspirin = ? big Harm?= ? big Benefits?
Also
The rule-in test for MI is quick to do and has, I'm led to believe
reasonable Sens & Spec. It is cheap!
With 'Acute Cerebral Syndrome' the rule-in test is both expensive and time
consuming.
If future studies demonstrate a beneficial endpoint with thrombolysis, in
the
management of 'Acute Cerebral Vascular Syndrome', then I suspect we will
need more CT's done in A&E, as well as friendly insomniac Radiologists!
The thought haunts me.
Not to mention the massive benefits of carotid endarterectomy in TIA's !
Regards
Adrian Kerner
SpR A&E Leeds
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