Purpose of Review: This article reviews the clinical evaluation of the patient with acute stroke, including key questions in the focused stroke history, important aspects of the National Institutes of Health Stroke Scale and focused neurologic examination, and the significance of the basic head CT scan in informing a timely treatment decision.
Recent Findings: Advances in both stroke treatment and enhanced diagnostics support an evolving paradigm for acute stroke care, ranging from the prehospital setting to the rehabilitative setting. An international emphasis on best practice strategies promotes efficiency and standardization in stroke systems of care.
Summary: Despite continual changes and augmentations to the field of acute stroke, several fundamentals remain. Central among these is in-depth knowledge of neurovascular anatomy, clinical stroke syndromes, and common mimics, which are foundational to the bedside evaluation of the patient with acute stroke.
Address correspondence to Dr Andrew M. Southerland, University of Virginia, Department of Neurology, Box 800394, McKim Hall, Room 2113, Charlottesville, VA 22908, As5ef@virginia.edu.
Relationship Disclosure: Dr. Southerland serves as deputy editor of the Neurology podcast and receives research/grant support from the American Academy of Neurology, American Board of Psychiatry and Neurology, Health Resources & Services Administration (HRSA GO1RH27869-01-00), and the National Institute of Neurological Disorders and Stroke (U01 NS069498).
Unlabeled Use of Products/Investigational Use Disclosure: Dr Southerland reports no disclosure.