Abstract

The standard approach to the assessment and implementation of therapeutic strategies for acute stroke within 4.5 hours is to adhere to a local protocol developed jointly by staff from the prehospital emergency service, hospital emergency department (ED), neuroradiology service, and acute stroke team. The protocol includes systems to receive early notification by paramedical staff, high-priority transportation and triage, rapid referral from ED staff to the stroke team, and immediate access to brain imaging.1 Plain CT brain scan remains the standard initial imaging strategy, but some specialist centers adopt advanced brain imaging (e.g., CT perfusion, MRI diffusion and perfusion) in a quest to improve selection for thrombolytic therapy.

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