STROKE-ECR CRITERIA, STROKE LESS THAN 6 HRS
SUMMARY
CRITERIA
1. Stroke symptoms treatable within 6 hours of onset or time last known well in wake‐up stroke
2. Patient has a pre‐morbid modified Rankin Scale (mRS) < 2; slight disability but independent personal ADLs
3. An acute neurological deficit (NIHSS > 5)
4. Imaging criteria:
a. Non‐contrast CT without a large infarct (> 1/3 MCA territory) or haemorrhage
b. CT angiogram (aortic arch to vertex of the brain) shows a large vessel occlusion (LVO) of the IC, M1 or proximal M2 branches or the Basilar artery
c. CT perfusion or MRI scan may be helpful but is not essential < 6 hours (broad imaging criteria)
EVIDENCE
Evidence suggests for patients with ischaemic stroke caused by LVO in the IC, proximal M1 segment, or with tandem occlusion of both the cervical carotid and intracranial large arteries, endovascular thrombectomy should be undertaken when the procedure can be commenced within six hours of stroke onset[1].
Reference(s)
- ↑ Goyal, M., Menon, B.K., Van Zwam, W.H., Dippel, D.W., Mitchell, P.J., Demchuk, A.M., Dávalos, A., Majoie, C.B., van Der Lugt, A., De Miquel, M.A. and Donnan, G.A., 2016. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. The Lancet, 387(10029), pp.1723-1731.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
