Australian and New Zealand Living Clinical Guidelines for Stroke Management - Chapter 2 of 8: Early assessment and diagnosis

Published by Stroke Foundation on Jul 28, 2023

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Disclaimer

These Clinical Guidelines are a general guide to appropriate practice, to be followed subject to the clinician’s judgment and the patient’s preference in each individual case. The Clinical Guideline is designed to provide information to assist decision-making and are based on the best evidence available at the time of development. The Clinical Guidelines can be viewed at www.informme.org.au - Citation: Stroke Foundation. Clinical Guidelines for Stroke Management. Melbourne Australia. © No part of this publication can be reproduced by any process without permission from the Stroke Foundation. June 2022.

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The Stroke Foundation gratefully acknowledges the previous financial assistance provided by the Australian Government, Medical Research Future Fund. The development of the recommendations has not been influenced by the views or interests of the funding body.

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Abstract

This is the second in a series of eight Clinical Guideline chapters that provide evidence-based recommendations for recovery from stroke and TIA in adults.

Language

en-au

PICOS

PICO 10.1

Population
Adults with suspected stroke
Intervention
CT
Comparator
Confirmed diagnosis of stroke
Outcomes

PICO 10.2

Population
Adults with suspected stroke
Intervention
MRI
Comparator
Confirmed diagnosis of stroke
Outcomes

PICO 10.3

Population
Adults with suspected stroke
Intervention
Thin slice non-contrast CT
Comparator
Confirmed diagnosis of vessel occlusion
Outcomes

PICO 10.4

Population
Adults with suspected stroke
Intervention
CT perfusion imaging
Comparator
Confirmed diagnosis of stroke
Outcomes

PICO 10.5

Population
Adults with ischaemic stroke and penumbral imaging
Intervention
Endovascular clot retrieval
Comparator
Control
Outcomes

PICO 10.6

Population
Adults with ischaemic stroke and MR perfusion-diffusion mismatch beyond 3hr of stroke onset
Intervention
Reperfusion achieved through intravenous thrombolysis with alteplase
Comparator
Reperfusion not achieved
Outcomes

PICO 10.7

Population
Adults with ischaemic stroke and MR perfusion-diffusion mismatch beyond 6hr of stroke onset
Intervention
Reperfusion achieved through endovascular clot retrieval
Comparator
Reperfusion not achieved
Outcomes

PICO 10.8

Population
Patients with carotid artery stenosis
Intervention
Imaging
Comparator
Surgical specimen
Outcomes

PICO 10.9

Population
Patients suspected of having carotid artery stenosis
Intervention
Ultrasound, CT and MR angiography
Comparator
Digital subtraction angiography
Outcomes

PICO 10.10

Population
Patients eligible for endovascular clot retrieval based on clinical severity
Intervention
Non-invasive angiography (CT or MR)
Comparator
Patients eligible for endovascular clot retrieval based on proven large vessel occlusion on non-invasive angiography
Outcomes

PICO 10.11

Population
Patients suspected of having intracranial stenosis
Intervention
Transcranial doppler
Comparator
Digital subtraction angiography, CTA or MRA
Outcomes

PICO 30.1

Population
Adults with acute stroke
Intervention
Continuous ECG monitoring
Comparator
Standard ECG
Outcomes

PICO 30.2

Population
Adults with stroke
Intervention
Long term ECG monitoring
Comparator
Short term ECG monitoring
Outcomes

PICO 30.3

Population
Adults with cardiac conditions as potential sources of stroke or TIA
Intervention
Echocardiography
Comparator
Reference standard
Outcomes

PICO 50.1

Population
All adults with suspected TIA
Intervention
Risk prediction scores
Comparator
Confirmed diagnosis of recurrent stroke
Outcomes

PICO 50.2

Population
All adults with suspected TIA in primary care setting
Intervention
Decision support tool
Comparator
Confirmed diagnosis of recurrent stroke
Outcomes

PICO 50.3

Population
All adults with suspected TIA/minor stroke
Intervention
Lesion on brain imaging
Comparator
Confirmed diagnosis of recurrent stroke
Outcomes

PICO 50.4

Population
All adults with suspected TIA
Intervention
Rapid assessment and treatment
Comparator
Control
Outcomes

PICO 60.1

Population
Adults with suspected stroke
Intervention
Stroke screening tool
Comparator
Confirmed diagnosis
Outcomes

PICO 60.2

Population
Adults with suspected stroke
Intervention
Clinical scales
Comparator
Confirmed diagnosis
Outcomes

PICO 60.3

Population
Adults with suspected stroke
Intervention
Biomarkers
Comparator
Confirmed diagnosis
Outcomes

PICO 60.4

Population
Adults with suspected stroke
Intervention
Rapid management
Comparator
Usual care
Outcomes