Overview
The Stroke Clock and the Tissue at Risk
A new facial droop, unilateral weakness, speech disturbance, visual loss, or sudden loss of balance is a stroke emergency until proven otherwise.
A new facial droop, unilateral weakness, speech disturbance, visual loss, or sudden loss of balance is a stroke emergency until proven otherwise. The first questions are not whether the symptom is mild or whether it has resolved. They are: when was the patient last known well, could this be hypoglycaemia, and is there intracranial bleeding? TIA and non-disabling stroke stay on the same urgent pathway as disabling stroke. A patient whose symptoms began within the previous 48 hours should go immediately to an emergency department with stroke-care capacity; a patient presenting later still needs comprehensive assessment as soon as possible by a clinician with stroke expertise. Resolution is not reassurance—it is a warning that another, potentially disabling event may follow.