Escolar Documentos
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F.A.S.T.
TACI: Total Anterior Circulation Infarct. (dysphasia/dyscalculia/visuospatial disorder), homonymous visual field/ipsilateral motor and/or sensory deficit of at least two areas- face arm or leg. PACI: two of the three components of TACI. LACI: pure motor/pure sensory/sensory-motor, or ataxic hemiparesis. POCI: cerebellar/brainstem a wide range of components
Oxfordshire (Bamford)
Total Anterior Circulation Infarct (TACI) 20% of strokes/would benefit from thrombolysis/thrombotic Partial Anterior Circulation Infarct (PACI) 35% of strokes/occluded branches of the MCA/mostly embolic. Lacunar Infarct (LACI) 20% of stroke/often silent and under diagnosed/need MRI/HTN bleeds/embolic. Posterior Circulation Infarcts (POCI) 25% of stroke/brainstem, cerebellar or occipital lobes/complex presentations/thrombosis embolism.
TACI 40% 55 5 60 35 5 PACI 5 40 55 15 30 55 LACI 5 30 65 10 30 60 POCI 5 30 65 20 20 60
30 days
1 year
C = Clinical findings: unilateral weakness = 2 pts Speech impairment = 1 pt (with no weakness) D = Duration > 60 mins = 2 points 10-59 mins = 1 point D = Diabetes = 1 point Tool Interpretation: > 4 High risk < or = 4 Low risk
Maximum score 7
FIM
Functional Independence Measure Only used by us as a baseline for rehabilitation. Becoming more popular
We dont use:
NIHSS too lengthy/training reqd Intracerebral Haemorrhage score mainly around mortality scores in intraparenchymal ICBs. Barthel very broad disability measure of 10 items. Rankin 8 items
My own personal:
Coma/LOC Pupillary disturbances Cheyne-Stokes respirations Paralysis of conjugate gaze Continence Dysphagia
= poor outcome
The End
References
Bakas, T., Austin, J., Okonkwo, K., Lewis, R. & Chadwick, L. (2002) Needs concerns, strategies and advice of stroke caregivers in the first 6 months after stroke. Journal of Neuroscience Nursing, 34(5) 245. Chumney, D.,Nollinger, K., Sheska, K.et al. The Ability of the Functional Independence Measure to accurately predict functional outcome of a stroke specific population: a systematic review. Journal of Rehabilitation Research and Development. 47, (1). 17-30 NollingerWwww.rehab.research.va.gov/jour/10/471/pdf/chumney.pdf Stroke Recovery and Rehabilitation (2009). Joel Stein et al (eds). New York; DemosMedical Publishing Stroke Foundation of New Zealand. Clinical Guidelines for Stroke Management. (2010) (Consultation Draft) Wellington. New Zealand