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1. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

occlusion of the proximal posterior circulation (that is, basilar or posterior cerebral artery) demonstrated by CTA or MRA and and Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 9 of 38if there is the potential to salvage brain tissue, as shown by imaging such as CT perfusion or diffusion-weighted MRI sequences showing limited (...) ) for people with acute stroke who meet all of the following criteria: Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 17 of 38clinical deficits that suggest infarction in the territory of the middle cerebral artery, with a score above 15 on the NIHSS decreased level of consciousness, with a score of 1 or more on item 1a

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

2. Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling

suffer neurological deterioration attributable to cerebral swelling after ischemia. Hemispheric Stroke Patients with significant swelling typically have occlusions of the internal carotid artery, MCA, or both. The natural history of a large infarction after internal carotid artery versus MCA infarction is not clear, especially when independent of ante- rior cerebral artery territory infarction. Infarctions from MCA branch occlusions typically do not result in swelling with clinically significant mass (...) Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling 1222 Background and Purpose—There are uncertainties surrounding the optimal management of patients with brain swelling after an ischemic stroke. Guidelines are needed on how to manage this major complication, how to provide the best comprehensive neurological and medical care, and how to best inform families facing complex decisions on surgical intervention in deteriorating patients. This scientific statement

2014 Congress of Neurological Surgeons

3. Canadian Stroke Best Practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; 6th edition update 2019

be costly, or forgo super- vised therapy and potentially not meet their rehabilita- tion and recovery potential. The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR): Rehabilitation and Recovery following Stroke module is a comprehen- sive summary of current evidence-based recommenda- tions, focusing primarily on the management of people who have already had a moderately or severely dis- abling stroke. People with milder stroke or transient ischemic attack may not require (...) for select patients with acute stroke (for instance, people with more mild strokesor transient ischemic attack) butcautionisadvised, andclinical judgmentshouldbeused(Evidence Level C). (iv) Once deemed to be medically and neurologically stable, patients should receive a recommended three hours perdayof directtask-specific therapy, five days aweek, delivered by the interdisciplinary stroke team (Evidence Level C); more therapy results in better outcomes (Evidence Level A). (v) Individualized

2020 CPG Infobase

4. Stroke rehabilitation and community reintegration. Initial stroke rehabilitation assessment. In: Canadian best practice recommendations for stroke care.

Stroke rehabilitation and community reintegration. Initial stroke rehabilitation assessment. In: Canadian best practice recommendations for stroke care. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes

2010 Canadian Stroke Network

5. Stroke rehabilitation and community reintegration. Provision of inpatient stroke rehabilitation. In: Canadian best practice recommendations for stroke care.

Stroke rehabilitation and community reintegration. Provision of inpatient stroke rehabilitation. In: Canadian best practice recommendations for stroke care. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered

2010 Canadian Stroke Network

6. Stroke rehabilitation and community reintegration. Components of inpatient stroke rehabilitation. In: Canadian best practice recommendations for stroke care.

Stroke rehabilitation and community reintegration. Components of inpatient stroke rehabilitation. In: Canadian best practice recommendations for stroke care. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered

2010 Canadian Stroke Network

7. Stroke rehabilitation and community reintegration. Follow-up and community reintegration. In: Canadian best practice recommendations for stroke care.

Stroke rehabilitation and community reintegration. Follow-up and community reintegration. In: Canadian best practice recommendations for stroke care. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes

2010 Canadian Stroke Network

8. The Subacute Rehabilitation of Childhood Stroke, Clinical Guideline

, representing a 15 fold cost increase compared to controls 5 . Of note, this figure does not capture costs of families including loss of income, reduced employment, rehabilitation expenses, and psychosocial consequences for child and family. Costs are higher for childhood than for neonatal stroke, and higher for haemorrhagic than ischaemic stroke 5 . Higher costs correlate with worse impairment, emphasising the importance of rehabilitation to maximise recovery 6 . The key difference between children (...) population This guideline addresses the subacute management and care of acute arterial ischaemic stroke and non-traumatic intracranial haemorrhage in children (aged 29 days to 18 years or until school completion). The scope of this guideline does not include perinatal (aged 28 days or younger at stroke onset), subdural haemorrhage secondary to trauma, spinal stroke syndromes or cerebral venous thrombosis without infarction.Victorian Subacute Childhood Stroke Guidelines 8 3. METHODOLOGY 3.1. G u i d e l i

2017 Stroke Foundation - Australia

9. Management of Stroke Rehabilitation

in Patients with Stroke and Transient Ischemic Attack [23] Abbreviations: AHA: American Heart Association; ASA: American Stroke Association Sidebar 2: Assessment of Impairments and Disabilities ? Assessment of impairments • Auditory/hearing • Bowel and bladder function • Cognition • Communication • Emotion and behavior • Inattention/neglect • Motor/mobility • Swallowing and nutrition • Tactile/touch • Vision function and formal visual field ? Assessment of barriers to participation in therapy • Cognitive (...) in the form of medical, surgical, or rehabilitation interventions is essential to help reduce disability severity, decrease the risk of further complications, and lessen potentially life-long deficits.[5,6] Unfortunately, in approximately 30% of ischemic stroke cases, the cause of the stroke remains unknown.[7] Ischemic strokes with no obvious cause are labelled as “cryptogenic” strokes and are more common in younger patients than in the elderly.[8] This is largely due to the lack of comorbidities

2019 VA/DoD Clinical Practice Guidelines

10. Guidelines for adult stroke rehabilitation and recovery

. The end of formal rehabilitation (commonly by 3–4 months after stroke) should not mean the end of the restorative process. In many respects, stroke has been managed medically as a temporary or transient condi- tion instead of a chronic condition that warrants monitoring after the acute event. Currently, unmet needs persist in many domains, including social reintegration, health-related qual- ity of life, maintenance of activity, and self-efficacy (ie, belief in one’s capability to carry out a behavior (...) , the delivery of acute stroke treatments, and the initiation of pro- phylactic and preventive measures. Although the delivery of rehabilitation therapies (OT/PT/SLT) is generally not the first priority, data strongly suggest that there are benefits to starting rehabilitation as soon as the patient is ready and can tolerate it. 11 The cardinal feature of acute inpatient care for stroke patients in the United States is its brevity; the median length of stay for patients with ischemic stroke in only 4 days

2016 American Academy of Neurology

11. Management of Stroke Rehabilitation

only focused on the rehabilitation phase of the post-acute care. Secondary Prevention of Stroke will not be addressed in this update. Providers may refer to the revised AHA/ASA Guideline for Prevention of Stroke in Patients with Ischemic Stroke or Transient Ischemic Attack (http://stroke.ahajournals.org/cgi/content/full/37/2/577).. Duncan, Horrner and colleagues (2002) found that greater adherence to post-acute stroke rehabilitation guidelines was associated with improved patient outcomes (...) of rehabilitation is to prevent complications, minimize impairments, and maximize function. • Secondary prevention is fundamental to preventing stroke recurrence (see: AHA/ASA Guideline for Prevention of Stroke in Patients with Ischemic Stroke or Transient Ischemic Attack). • Early assessment and intervention is critical to optimize rehabilitation. • Standardized evaluations and valid assessment tools are essential to the development of a comprehensive treatment plan. • Evidence-based interventions should

2010 VA/DoD Clinical Practice Guidelines

12. Stroke rehabilitation practice guidelines

Stroke rehabilitation practice guidelines SAGE Journals: Your gateway to world-class journal research MENU Sign In Institution Society Access Options You can be signed in via any or all of the methods shown below at the same time. My Profile Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions Email (required) Password (required) Remember me I don't have a profile I am signed in as: With my free profile I can: Set up and register for List

2015 CPG Infobase

13. Stroke rehabilitation in adults

Stroke rehabilitation in adults Strok Stroke rehabilitation in adults e rehabilitation in adults Clinical guideline Published: 12 June 2013 nice.org.uk/guidance/cg162 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement (...) . Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Stroke rehabilitation in adults (CG162) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 43Contents Contents Introduction 5 Current guidelines 5 Why this guideline was developed 6 Patient-centred

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

14. AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery

to span the entire course of rehabilitation, from the early actions taken in the acute care hospital through reintegration into the community. The end of formal rehabilitation (commonly by 3–4 months after stroke) should not mean the end of the restorative process. In many respects, stroke has been managed medically as a temporary or transient condition instead of a chronic condition that warrants monitoring after the acute event. Currently, unmet needs persist in many domains, including social (...) , and the initiation of prophylactic and preventive measures. Although the delivery of rehabilitation therapies (OT/PT/SLT) is generally not the first priority, data strongly suggest that there are benefits to starting rehabilitation as soon as the patient is ready and can tolerate it. The cardinal feature of acute inpatient care for stroke patients in the United States is its brevity; the median length of stay for patients with ischemic stroke in only 4 days. Regardless of whether rehabilitation is started during

2016 American Heart Association

15. Stroke in childhood - clinical guideline for diagnosis, management and rehabilitation

Stereotactic radiosurgery SSNAP Sentinel Stroke National Audit Programme STOP Stroke Prevention Trial in Sickle Cell Anaemia SWiTCH trial Stroke With Transfusions Changing to Hydroxyurea trial TAC/F Team Around the Child/Family TBI Traumatic brain injury TCD Transcranial Doppler ultrasonography TIA Transient ischaemic attack TIPS trial Thrombolysis in Pediatric Stroke trial TMS Transcranial magnetic stimulation tPA Tissue plasminogen activator UKHCDO United Kingdom Haemophilia Centre Doctors' Organisation (...) assessment 38 5.2 Framework for early functional assessment 41 vi 5.3 Prevention, identification and management of complications 45 6. Arterial Ischaemic Stroke 49 6.1. Conditions and factors associated with a risk of AIS or recurrence 49 6.2. Medical and surgical interventions 59 7. Haemorrhagic Stroke 75 7.1. Conditions and factors associated with a risk of HS or recurrence 75 7.2. Medical and surgical interventions 82 8. Discharge from hospital 99 8.1. Discharge 99 9. Rehabilitation 103 9.1. Framework

2017 Royal College of Paediatrics and Child Health

16. Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (Secondary Stroke Prevention)

, will experience a transient ischemic attack (TIA). 2 Although a TIA leaves no immediate impairment, affected individuals have a Abstract—The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors (...) of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines. (Stroke. 2014;45:2160-2236.) Key Words: AHA Scientific Statements ? atrial fibrillation ? carotid stenosis ? hypertension ? ischemia ? ischemic attack, transient ? prevention ? stroke Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association The American Academy

2014 Congress of Neurological Surgeons

17. Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (Full text)

preeclampsia 1.66 (1.29–2.14) CI indicates confidence interval; HR, hazard ratio; OR, odds ratio; SGA, small for gestational age; and TIA, transient ischemic attack. * Defined as preeclampsia between 16 and 36 weeks. The basis of the association between preeclampsia and future stroke is not entirely known but is hypothesized to be possibly related to genetic factors; shared risk factors (hypertension, dyslipidemia, endothelial dysfunction) between preeclampsia/eclampsia or other pregnancy complications (...) study Preterm birth; SGA Cerebrovascular events (infarction, hemorrhage, subarachnoid hemorrhage, TIA, other stroke) Preterm birth 2.41 (1.4–4.17); SGA birth 1.68 (1.46–2.06); preterm and SGA birth 3.11 (1.91–5.09) Irgens et al, 2001 626 272 Retrospective cohort study Preeclampsia Stroke mortality Term preeclampsia 0.98 (0.5–1.91); preterm preeclampsia 5.08 (2.09–12.35) Wilson et al, 2003 1312 Retrospective cohort study Preeclampsia Stroke mortality 32 3.59 (1.04–12.4) Ray et al, 2005 1 026 265

2014 American Heart Association PubMed abstract

18. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack (Full text)

cholesterol; LMWH, low-molecular-weight heparin; LV, left ventricular; LVAD, left ventricular assist device; MI, myocardial infarction; PFO, patent foramen ovale; SAMMPRIS, Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis; STEMI, ST-elevation myocardial infarction; TIA, transient ischemic attack; UFH, unfractionated heparin; and VKA, vitamin K antagonist. * Includes recommendations for which the class was changed from one whole number to another (...) on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease Originally published 1 May 2014 Stroke. 2014;45:2160–2236 You are viewing the most recent version of this article. Previous versions: Abstract The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage

2014 American Heart Association PubMed abstract

19. Stroke, Diagnosis and Initial Treatment of Ischemic Stroke

early care for persons with an onset of stroke symp- toms. The recommendations in this guideline are for early management of stroke due to ischemic brain ischemia/infarction. This guideline does not address stroke prevention, transient ischemic stroke (TIA) or management of hemorrhagic stroke. To increase access to appropriate early care for stroke, Minnesota passed legislation to authorize the Minnesota Department of Health (MDH) to designate hospitals as Acute Stroke-Ready Hospitals, Primary (...) infarct” present yes Return to Table of Contents www.icsi.org 2 Table of Contents Diagnosis and Initial Treatment of Ischemic Stroke Twelfth Edition/June 2019 Work Group Co-Leaders David Anderson, MD Neurology, University of Minnesota Physicians David Larson, MD Emergency Medicine, Ridgeview Medical Center Work Group Members HealthEast Care System Tess Sierzant, MS, RN Neurology Nursing Lakeview Hospital Bjorn Peterson, MD Emergency Medicine Mayo Clinic James Klaas, MD Neurology Minneapolis Clinic

2019 Institute for Clinical Systems Improvement

20. Canadian stroke best practice recommendations: acute inpatient stroke care guidelines, update 2015

, intracerebral hemorrhage (ICH), and transient ischemic attack (TIA) (care may be expanded in some institutions to include patients with subarachnoid hemorrhage [SAH] and other neurovascular conditions); ? Dedicated stroke team with broad expertise – including neurology, nursing, neurosurgery, physiatry, rehabilitation professionals, pharmacists, and others; ? Consistent model where all stroke patients are cared for on the same hospital unit with dedicated stroke beds by trained and experienced staff (...) with mechanical embolectomy, for stroke patients admitted to a stroke unit, and for the management of intracerebral hemorrhage. Overall, the 2015 update highlights all aspects of in-hospital care that will optimize stroke outcomes. Canadian Stroke Best Practice Recommendations: Acute Inpatient Stroke Care Guidelines, Update 2015 Introduction Stroke is a burden across the globe; in Canadian hos- pitals, one patient is treated every 9min for a stroke or a transient ischemic attack (TIA). 3 Stroke is also

2015 CPG Infobase

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