CEA and treatment of hemorrhage

1. Under what circumstances is carotid endarterectomy recommended by the AHA?
2. What is the treatment for subarachnoid hemorrhage?
3. What is the treatment for intracranial hemorrhage?
4. What is the treatment for AVM?

Answers:
1. Symptomatic patients with one or more TIAs (or mild stroke) within past 6 months and >70% carotid stenosis.
2. Cardiac monitoring for arrhythmias, pain control, mannitol, BP control, aneurysm clipping early, nimodipine within 96 hrs.
3. Manage increased ICP and BP, possible surgical intervention.
4. Treatment for both symptomatic and asymptomatic AVM includes: surgical excision, embolization, proton beam therapy, radiosurgery/microsurgical resection for small AVMs.