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Stroke and transient ischaemic attack - Management
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The scope of this section
- This section covers the management of people presenting with ongoing neurological symptoms and signs that suggest an acute stroke or transient ischaemic attack (TIA).
- In this situation, it is not possible to differentiate between a stroke and a TIA, as TIA is a retrospective diagnosis that is made when symptoms have resolved. All people with current stroke symptoms should therefore be managed as if they have stroke.
How should I manage someone presenting with an acute stroke?
- Urgently admit all people with suspected acute stroke:
- Particular urgency is necessary for people who might be suitable for thrombolysis or whose clinical condition is poor (e.g. depressed level of consciousness, progressing symptoms, severe headache).
- A small number of people have severe comorbidity and might not benefit from admission. If, after discussion with the person and their family or carer, a decision is made not to admit, the reasons for this should be clearly documented.
- Do not start antiplatelet treatment until haemorrhagic stroke has been ruled out by a brain scan.
In depth
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