Acute Ischemic Stroke Management with Cerebral Amyloid Angiopathy

Immediate Management

The American Heart Association recommends protecting airway, breathing, and circulation as the patient is currently non-communicative but breathing independently 1
Monitor neurological status closely using standardized stroke severity assessment tools, as recommended by the American Stroke Association 4
Administer aspirin 325 mg within 24-48 hours of stroke onset to reduce risk of early recurrent stroke, as suggested by the American College of Cardiology 2, 3

The American College of Physicians recommends early mobilization as tolerated to prevent deep vein thrombosis, pulmonary embolism, and pressure sores 5
Use intermittent external compression stockings to prevent deep vein thrombosis, as recommended by the American Heart Association 5
Perform swallowing assessment before allowing oral intake to prevent aspiration, as suggested by the American Speech-Language-Hearing Association 5
Consider nasogastric or nasoduodenal tube for feeding if swallowing is impaired, as recommended by the American Gastroenterological Association 5
Monitor for and promptly treat infections, particularly pneumonia and urinary tract infections, as suggested by the Infectious Diseases Society of America 5
Assess for seizures, especially given the patient's reduced level of consciousness, as recommended by the American Academy of Neurology 6
Treat seizures if they occur but avoid prophylactic anticonvulsants, as suggested by the American Epilepsy Society 6

Transfer to a comprehensive stroke unit for specialized care as soon as medically stable, as recommended by the American Stroke Association 1
Implement early standardized assessment of somatosensory function to guide rehabilitation, as suggested by the American Occupational Therapy Association 4

Continue antiplatelet therapy (aspirin) for secondary stroke prevention, as recommended by the American College of Cardiology 7
Implement strict blood pressure control, as suggested by the American Heart Association 7
Address all modifiable risk factors for stroke recurrence, as recommended by the American Stroke Association 4