This is the first of what I hope to be regular summaries of the best of free open access resources on a specific topic.
From the basics to the latest research here is a run-down of some of the finest summaries.
Up first a common but surprisingly contentious presentation; acute treatment of Cerebral Vascular Accidents.
The basics
lIFE IN THE FAST LANE
A brief run down of acute treatment of CVA with links to evidence base. Quality you would expect from the LITFL team.
AMBOSS
A paid for site but with a free trial, this is a dense but detailed guide to the terminology and treatments around CVA.
Student blog
This is home made but hats off to creator but this is detailed breakdown of the basic treatment of stroke; both acute and the follow up period.
Pearls and pitfulls
The great series from these guys covers the basic of acute diagnosis and treatment of CVA.
The guidelines
NICE!
Before we move into the debate on new studies it is worth reviewing what we are actually meant to be doing
Unusual presentations
Posterior stroke
More from the emdocs gang; here are two good articles on diagnosis of posterior stroke using the HINTS exam and on unusual stroke presentations.
tHROMBOLYSIS; THE DEBATE
So thrombolysis is recommended by the guidelines. However, for those who understand the evidence it isn’t quite so simple. . .
the evidence explained
These guys have put together the most detailed review of all the RCT looking at thrombolysis.
Podcast review
This podcast breaks down a recent systematic review, but it is accessible and gives as always a nuanced answer to the difficult questions about implementing evidence into day to day practice.
tHE LATEST RESEARCH
Endovascular therapy is being hailed as the next best thing in acute stroke treatment. For those keen on original research; IMS 3, MR CLEAN, ESCAPE, EXTEN-IA, SWIFT-PRIME and RESCAT are the acronyms you need, otherwise here are some excellent summaries.
bMJ review
This open access (under creative commons) journal article from 2016 summarised the current status nicely. If you read one article on endovascular therapy this is the one.
Em nerd
For a more a sceptical look at the evidence, specifically the always insightful Rory Spiegel breaks it down here
eSCAPE review
The CORE-EM team break down the ESCAPE trial.
There are many more reviews out there, read at your leisure. Keen to add to this section as more FOAM goodness gets produced.