(Australian) Clinical Guidelines for Stroke Management 2017 - Chapter 2 of 8: Early assessment and diagnosis

Published by Stroke Foundation on Nov 21, 2019

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 Guidelines are designed to provide information to assist decision-making and are based on the best evidence available at the time of development. The guideline can be viewed and downloaded at www.informme.org.au - Citation: Stroke Foundation. Clinical Guidelines for Stroke Management 2017. Melbourne Australia. © No part of this publication can be reproduced by any process without permission from the Stroke Foundation. August 2017.

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The Stroke Foundation gratefully acknowledges the financial assistance provided by the Australian Government Department of Health. The development of the final 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.

Language

en

PICOS

PICO 1.1

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

PICO 1.2

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

PICO 1.3

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

PICO 1.4

Population
Adults with ischaemic stroke and CT perfusion mismatch beyond 6hr of stroke onset
Intervention
Endovascular clot retrieval
Comparator
Control
Outcomes

PICO 1.5

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 1.6

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 1.7

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

PICO 1.8

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

PICO 1.9

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 1.10

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

PICO 3.0

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

PICO 3.0

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

PICO 3.0

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

PICO 5.0

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

PICO 5.0

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

PICO 5.0

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

PICO 5.0

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

PICO 6.0

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

PICO 6.0

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

PICO 6.0

Population
Adults with suspected stroke
Intervention
Biomarkers
Comparator
Confirmed diagnosis
Outcomes

PICO 6.0

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