ABSTRACT
A detailed neurological examination is crucial to assessment in those who have had a suspected cerebrovascular event. Non-focal symptoms such as dizziness are unlikely to be due to a cerebrovascular event. Anticoagulation should be considered for patients who have had a cerebrovascular event and are in AF. The risk of a recurrent event is highest immediately following the index one; for this reason, patients should be assessed as soon as possible and have relevant secondary prevention commenced. Smokers should be educated on the benefits of quitting. While in hospital, nicotine patches may be required to reduce the incidence of withdrawal symptoms. Diabetic patients who have had a stroke should have their future blood sugar control optimised. The acute management of diabetes in the frail elderly is discussed on page 265. The Joint British Societies’ Guidelines recommend a blood pressure target of better than 130/80 mmHg for all patients following stroke.
