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CT angiogram (aortic arch to the circle of Willis): looking for large vessel occlusion, vessel dissection or stenosis. A LACS (lacunar stroke) is subcortical; therefore, higher cerebral functions (e.g. language) are preserved. Hence, these can be pure motor, sensory, sensorimotor, or cause ataxic hemiparesis alone. 3 Bamford stroke classification Haemorrhagic stroke Re-assess the patient using the ABCDE approach to identify any changes in their clinical condition and assess the effectiveness of your previous interventions.

Hypertension can cause stroke through end-organ damage (this is known as a hypertensive emergency and tends to occur at BP >200 mmHg systolic) Are we anywhere near to a breakthrough? So far, research has produced modest yields. Gerontologists speak prophetically of potential, but most warn a significant human development remains somewhere far off in the distance – almost in sight but not quite. Richard Hodes, the director of the National Institute of Aging, a US government agency, told me that, though research in animals has led to “dramatic increases in lifespan”, some of them multi-fold, “There has been far less quantitative effect as those models have moved towards mammalian species.” The biologist Laura Deming, who in 2011 established the Longevity Fund, a venture capital firm that supports “high-potential longevity companies”, told me that startups continue to successfully root out biological markers of ageing – inefficient cells, mitochondrial decline – but that, in humans, “We really don’t know right now what will work and what won’t.” Among Sierra Sciences competitors is BioViva, whose CEO, Elizabeth Parrish, is so committed to the cause that she became one of the first humans to undergo telomere therapy in 2015. Writing in 2018, she claimed a measurement of her telomeres showed they had “grown younger” by roughly 30 years since she received the treatment – her body was reverse-aging.A normal SpO 2 range is 94-98% in healthy individuals and 88-92% in patients with COPD who are at high risk of CO 2 retention. Insert at least one wide-bore intravenous cannula (14G or 16G) and take blood tests as discussed below.

Identification and management of atrial fibrillation (including anticoagulation): the timing of starting anticoagulation will depend on the size of the stroke In any case, it is likely that one single longevity strategy alone won’t help us much. Life extensionists enjoy a metaphor: humans are complicated machines, they say, like cars, but mushy. And what happens to a machine if you don’t look after it? It rusts. It splutters and spurts, until it reaches its inevitable conclusion. De Grey considers ageing a “multifaceted problem”. Humans incur many different types of damage. We don’t just rust. We scratch. We dent. Rubbish accumulates in our footwells and grime develops in our engines. We require multiple strategies of repair – constant fine-tuning. What’s the point in removing those senescent cells if that molecular junk continues to build up? Repeat administration of fluid boluses up to four times (e.g. 2000ml or 1000ml in patients at increased risk of fluid overload), reassessing the patient each time. There are several conditions which can mimic a stroke. When assessing a suspected stroke patient, it is important to consider these differentials. Review the patient’s drug chart for medications which may cause neurological abnormalities (e.g. opioids, sedatives, anxiolytics). National Institutes of Health Stroke Scale (NIHSS)

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Revisit history taking to identify risk factors for stroke and explore relevant medical history. If the patient is confused you might be able to get a collateral history from staff or family members as appropriate. Symptoms of stroke vary depending on the type of stroke and the area of the brain affected. For more information on history taking, see our guide to stroke and TIA history taking. Ischaemic stroke What good is all of this? The current life-extensionist strategy is twofold. First, achieve a “wellness foundation,” Strole says. Second, stay alive until the coming gerontological breakthrough. All that is required is to “live long enough for the next innovation,” and presuming you do, “You can buy another 20 years.” Twenty years here, 20 years there, it all adds up, and suddenly you’re 300. This is a common view. Last year the British billionaire Jim Mellon, who has written a book on longevity, titled Juvenescence, said: “If you can stay alive for another 10 to 20 years, if you aren’t yet over 75 and if you remain in reasonable health for your age, you have an excellent chance of living to more than 110.” To most, 110 seems a modest target. Why not forever? “It’s not some big quantum leap,” Strole says, by way of explanation. He invokes the analogy of a ladder: “step by step by step” to unlimited life. In 2009 the American futurist Ray Kurzweil, another supplement enthusiast, coined a similar metaphor, referring instead to “bridges to immortality”. All hospitals admitting stroke patients should have a specialist stroke rehabilitation ward, or should have immediate access to one. Using your thumbs, slightly open the mouth by downward displacement of the chin. Oropharyngeal airway (Guedel)