Stroke: national clinical guideline for diagnosis and initial management of acute stroke and transient ischaemic attack (TIA)

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Developed by the National Collaborating Centre for Chronic Conditions, published July 2008

Until recently, stroke was not perceived as a high priority within the NHS. However, following the publication of the National Audit Office report in 2005, a National Stroke Strategy was developed by the Department of Health in 2007, providing standards for the diagnosis, treatment and management of stroke, including all aspects of care.

This guideline covers interventions in the acute stage of a stroke or transient ischaemic attack (TIA). Most of the evidence considered related to interventions in the first 48 hours after onset of symptoms, although some interventions of up to two weeks are covered as well.

The guideline, which is available to purchase or download as a pdf, is an invaluable resource for general physicians, neurologists, nurses, clinicians, stroke medicine consultants and healthcare professionals who can contribute to the management and care of patients suffering from acute stroke and TIA.

Implementing this guideline across the country should be of real and immediate benefit to all patients with this once-neglected problem.


  • The development
  • Introduction
  • Methodology
  • Key messages of the guideline
  • Glossary and definitions
  • The guideline
  • The rapid recognition of symptoms and diagnosis
  • Imaging in TIA and non-disabling stroke
  • Specialist care in acute stroke
  • Pharmacological treatments for people with acute stroke
  • Maintenance or restoration of homeostasis
  • Nutrition and hydration
  • Early mobilisation and optimum positioning of people with acute stroke
  • Avoidance of aspirational pneumonia
  • Surgery for people with acute stroke
  • Research recommendations

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