Table 1 Summary of guideline recommendations – diagnosis, specialist assessments and pharmacological management
Recommendations | Further information |
|---|---|
Direct admission to specialised stroke unit | |
Diagnostic tests | Neuroimaging (non-contrast CT/MRI) |
Secondary diagnostic tests | ECG and other cardiac investigations if indicated Vascular imaging, e.g. CT/MR angiography and duplex ultrasonography |
Specialists’ assessments | Neurologist, nutritionist, physiotherapist, speech therapist, rehabilitation therapists |
Pharmacological management | |
Thrombolysis | Intravenous alteplase within 3–4.5 h of symptoms for fibrinolysis |
Antiplatelet therapy | Aspirin (acetyl salicylic acid) primarily (alternates: Clopidogrel or Dipyridamole) Acute use (associated with slight reduction in mortality and morbidity) Prescribed on discharge (secondary prophylaxis) |
Anticoagulants | Avoid routine use except if at risk of thromboembolism |
Statins | Avoid routine use Advised for secondary prophylaxis |