Stroke units and clinical assessment

Abstract

Introduction There is strong evidence that treatment of stroke patients in stroke units significantly reduces death, dependency and need for institutional care compared to treatment in general medical wards [1]. An acute stroke unit is one of the key elements in the critical pathway and the chain of recovery of acute stroke patients. Only stroke unit care, thrombolytic therapy and hemicraniectomy have been shown to improve the outcome of stroke patients. The acute therapies and interventions in stroke are described in Chapter 16. The basic functions of the stroke unit, mainly covered in other chapters of this book, are etiological diagnostic work-up (Chapters 2–4 and 7–13), general management and proactive prevention of complications (Chapters 17 and 18), secondary prevention of stroke and other vascular endpoints (Chapter 19), and early rehabilitation (Chapter 20). The purpose of this chapter is to characterize the chain of recovery of acute stroke patients from emergency phone call to acute stroke unit, including clinical evaluation of the patient and aspects of general stroke management that can be optimally delivered in stroke units, in light of current guidelines.