Table 4

Stroke and TIA

Diagnostic criteria
 Acute episode of a focal or global neurological deficit with at least one of the following: change in the level of consciousness, hemiplegia, hemiparesis, numbness, or sensory loss affecting one side of the body, dysphasia or aphasia, hemianopia, amaurosis fugax, or other neurological signs or symptoms consistent with stroke
 Stroke: duration of a focal or global neurological deficit >24 h; OR <24 h if available neuroimaging documents a new haemorrhage or infarct; OR the neurological deficit results in death
 TIA: duration of a focal or global neurological deficit <24 h, any variable neuroimaging does not demonstrate a new hemorrhage or infarct
 No other readily identifiable non-stroke cause for the clinical presentation (e.g. brain tumour, trauma, infection, hypoglycemia, peripheral lesion, pharmacological influences), to be determined by or in conjunction with the designated neurologist
 Confirmation of the diagnosis by at least one of the following:
  Neurologist or neurosurgical specialist
  Neuroimaging procedure (CT scan or brain MRI), but stroke may be diagnosed on clinical grounds alone
Stroke classification
 Ischemic: an acute episode of focal cerebral, spinal, or retinal dysfunction caused by infarction of the central nervous system tissue
 Hemorrhagic: an acute episode of focal or global cerebral or spinal dysfunction caused by intraparenchymal, intraventricular, or subarachnoid hemorrhage
 A stroke may be classified as undetermined if there is insufficient information to allow categorization as ischemic or haemorrhagic
Stroke definitions
 Disabling stroke: an mRS score of 2 or more at 90 days and an increase in at least one mRS category from an individual's pre-stroke baseline
 Non-disabling stroke: an mRS score of <2 at 90 days or one that does not result in an increase in at least one mRS category from an individual's pre-stroke baseline

mRS = modified Rankin Scale.

  • Patients with non-focal global encephalopathy will not be reported as a stroke without unequivocal evidence of cerebral infarction-based upon neuroimaging studies (CT scan or Brain MRI).

  • Modified Rankin Scale assessments should be made by qualified individuals according to a certification process (23–25).