Core Module

Stroke

Introduction

Cerebrovascular Accident (CVA) or stroke is a common neurological presentation that can have a very varied presentation depending on the vascular territory involved. Similarly the management of stroke can greatly vary between patients depending on severity, time of onset, patient factors and available medical services. This session aims to provide a comprehensive overview of stroke presentation, risk factors, basic initial management and secondary prevention while introducing students to more advanced stroke investigations and management.

Content Contributors:

Author: Dr Nicholas Hewett

EDITOR: Dr Nicholas Hewett
CONTENT APPROVAL: Dr Bill O’Brien

Version History Version
Version 1 – August 2019

  • It requires 30 minutes preparation.

  • It can be taught in 1 hour


Teaching approach

As with all modules, familiarise yourself with the NPMT principles.

session learning objectives:

  • To be able to define a stroke and other key acute neurological terminology used 

  • To feel confident identifying key risk factors for stroke

  • To be aware of tools utilised to identify strokes

  • Key history aspects to discern in evaluating a stroke

  • Students should be able to provide a differential diagnosis list for the acute neurological presentation 

  • Students should be able to identify the key vascular distributions in the brain and how they relate to typical stroke syndromes 

  • To be able to describe basic initial management and investigation priorities in a stroke call 

  • To be able to identify the potential acute management options available in acute stroke

  • Students should feel confident identifying secondary prevention strategies and necessary investigations required in this work up.

Tips & Tricks on running an effective session:

  • Stroke is obviously a large topic and can be very detailed, it is important to not become too stuck in this detail during the presentation

  • A guide to the level of detail will be the year level and relative experience of the student group 

  • Utilising multiple aids to the presentation will be of great use in maintaining student attention throughout this tutorial. As such the lesson plan includes whiteboard usage, PowerPoint and a worksheet for students to aid structured notetaking for later review. 

  • Imaging is not a key focus of this talk, however if students are interested and this is identified as a focus there is an additional imaging section with a brief overview of this. 

  • The more interactive these tutorials are the more students are likely to get out of them so ensure questions are asked and pitched at the right level – starting with easy questions will help introduce the audience into a safe space to respond 

    • It may be helpful at the beginning of the session to highlight that there are no silly answers or questions, especially for junior years. Describe the question strategy you are going to pursue (See the teaching section of the website for guides on how to engage groups)

  • This is a LARGE tutorial – and the relative weight to each section and approaches should be considered prior to presenting. An outline of potential options are below:

    • Early clinical year/pre-clinical – focus should be on collaborative discussion of aims 1-6, and the final aims are more likely require tutors to engage in a more lecture based teaching style with less weight and time devoted to this. This should be explained to students, and highlighted that further presentations will build on these foundations before focusing on management principles. 

    • Later clinical years/PRINT terms – The focus should be shifted towards stroke identification through Hx/exam and early management

    • A discussion can also be had with students at the start where they pick 3-4 aims to focus on after being shown the outline of the talk

Resources: