Conditions
- Aneurysm/vascular malformation
- Stroke (ischaemic and
haemorrhagic)
- Subarachnoid haemorrhage
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients* and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Aetiology and risk factors for neurological diseases
- Anatomy and pathophysiology of neurological conditions
- Clinical patterns of illness
- Common stroke mimics
- Epidemiology, incidence and prevalence, mortality and morbidity
of stroke and other neurological conditions in Australia and Aotearoa
New Zealand
- Factors associated with good and poorer prognoses
- Natural history
- Nature and consequences of neurological disorders that result
in major disability and activity limitation or participation restriction
- Neuroanatomical correlation with specific deficits
- Patterns of dysfunction with neurological disease
- Signs and symptoms
- Stroke rehabilitation outcomes, including recent studies of the
effectiveness of inpatient, outpatient, and community rehabilitation
Examinations
- Functional and cognitive assessment
- Neurological examination
- Other relevant systems examination, e.g. cardiovascular,
respiratory, skin
Investigations
- Blood tests associated with diagnosis and prevention of
neurological conditions
- Carotid ultrasonography and contrast carotid angiography
- Cerebrospinal fluid (CSF)
- CT scan
- MRI
- Neurophysiological studies and electroencephalography
- Radiological and endoscopic assessment of swallowing
- Tools for measurement of neurological disability, e.g.
Modified Rankin Scale (MRS), National Institute of Health
Stroke Scale (NIHSS)
- Transthoracic and transoesophageal echocardiography
- X-ray and ultrasound
Activities of daily living (ADL)
- Arm activity
- Home assessment
- Sexual intimacy and sexual dysfunction post-stroke
- Sitting, standing, and walking
Acute management
- Deep venous thrombosis or pulmonary embolism
- Early mobilisation
- Falls risk assessment
- Hydration
- Neuroprotection
- Palliative care
- Pharmacotherapy
- Pressure injuries
- Secondary prevention
- Surgical interventions
Chronic/long term management issues
- Adherence to pharmacotherapy
- Carer training
- Lifestyle medication
- Prevention of stroke re-occurrence
Common complications – types of dysfunctions
- Bladder and bowel:
- functional incontinence
- urinary retention
- Cognition and perception:
- attention and concentration
- executive function
- fatigue
- limb apraxia
- memory
- neglect
- visual field deficit, e.g. hemianopia, and eye movement disorders such as strabismus and motility deficit
- Communication:
- aphasia, speech, and language
- dysarthria
- Mood and behaviour:
- anxiety, depression, emotionalism
- behavioural changes
- Nutrition and swallowing:
- dysphagia
- indirect motor therapy
- oral hygiene
- risk of malnutrition and dehydration
- skill and strength training in direct therapy (with food/fluids)
- Physical deficits:
- cardiovascular fitness
- contracture
- exercise interventions
- fatigue
- loss of sensation
- pain
- spasticity
- subluxation
- swelling
- weakness
Community reintegration
- Community mobility
- Driving
- Leisure therapies
- Ongoing support – peer and carer
- Return to work options
- Self-management programs
