COVID effects on ‘mini stroke’ in focus

Description

 

Monash Health researchers have led an international study that looked at the effect of COVID-19 on the management pathway of transient ischemic attack (TIA) treatment pathways.

A TIA is a ‘mini-stroke’ which needs to be assessed quickly and adequately to reduce the risk of future strokes.

With rapid access pathways, the risk of having a stroke in the following three months can be decreased from one in 10 to one in 50.

To lower COVID-19 risks, however, face-to-face contact at hospitals around the world has been reduced, which can impact the effectiveness of TIA treatment pathways.

‘Before COVID-19, if a patient was deemed appropriate for TIA pathway management, they would usually get a carotid ultrasound done within 24 hours – as an outpatient – to identify any significant carotid artery stenosis,’ said adjunct professor, director of neurology and head of the stroke unit at Monash Health Henry Ma.

‘During COVID-19, we tried to reduce patient contact and avoid asking the patient to return the next day.

‘Instead, we performed the CT during the initial emergency presentation.

‘This provided an immediate assessment of the carotid artery, which could then guide treatment.’

Follow-up of ‘mini stroke’ patients can also be performed via telehealth, another measure which reduces the risk of COVID-19.

A global review of TIA treatment, conducted by Monash Health researchers, showed that all countries continued to support rapid access pathways throughout the pandemic, which highlights the importance of the treatment compared to other services and treatments that have been put on hold.

The research report was a global collaboration to study the impact of COVID-19 on the delivery of acute stroke care.

‘More importantly, it also showed how health professionals had responded to the changes and ensured we can provide the best possible care,’ said Professor Ma.

Emergency physician Dr Andy Lim led the collaboration between the emergency and neurology departments at Monash Health.

The global report showed that the adaptive practices at Monash Health were delivering TIA rapid access pathways at a pace that matched other world-leading hospitals and universities.