Acute Stroke Management: A Comprehensive Emergency Guideline

Evidence-based guideline for recognition, evaluation, thrombolysis, thrombectomy, and management of ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage in the emergency department.

5 articles • Updated Mar 2026

Acute Stroke Management — Part 5: Subarachnoid Hemorrhage, TIA & Special Populations

SAH presentation, Hunt & Hess scale, WFNS grade, Fisher CT grading, aneurysm management, vasospasm prevention, DCI, TIA evaluation (ABCD2, dual antiplatelet), stroke mimics, posterior circulation, wake-up stroke, pregnancy, and pediatric stroke.

guidelines•Mar 2026•guidelines

Acute Stroke Management — Part 4: Intracerebral Hemorrhage

ICH pathophysiology, ICH Score, hematoma expansion, blood pressure management (INTERACT2, ATACH-2), anticoagulant reversal protocols, surgical intervention criteria (STICH, MISTIE III, ENRICH), and ICP management.

guidelines•Mar 2026•guidelines

Acute Stroke Management — Part 3: Endovascular Thrombectomy & Blood Pressure Management

EVT indications, landmark trials, extended window therapy (DAWN, DEFUSE-3), anesthesia considerations, and comprehensive blood pressure management with antihypertensive dosing tables.

guidelines•Mar 2026•guidelines

Acute Stroke Management — Part 2: Intravenous Thrombolysis

Alteplase and tenecteplase dosing, complete inclusion/exclusion criteria for 0-3h and 3-4.5h windows, blood pressure management peri-thrombolysis, orolingual angioedema, and hemorrhagic transformation.

guidelines•Mar 2026•guidelines

Acute Stroke Management — Part 1: Prehospital Recognition, ED Evaluation & Neuroimaging

Stroke types, prehospital stroke scales (CPSS, LAMS, RACE, FAST-ED), complete NIHSS scoring, focused history, laboratory evaluation, and neuroimaging (NCCT, CTA, CTP, MRI/DWI, ASPECTS).

guidelines•Mar 2026•guidelines