ABSTRACT
Patients with established cerebrovascular accidents (CVA) are usually cared for on designated stroke units, which provide specialist medical, nursing, and therapy input. Strokes, or CVAs, represent a significant cause of morbidity and mortality with an average incidence of 1/100 in those aged greater than 75. Thrombolysis with alteplase is considered for patients with acute ischaemic stroke, with no evidence of haemorrhage, who present within a 4.5-hour window from symptom onset. These account for 80% of all strokes and are the result of either a thrombosis superimposed upon an atherosclerotic plaque within a cerebral artery or an embolic event. In theory, a true embolic stroke will produce a very acute onset of symptoms with maximal neurological deficit seen immediately, whereas an infarct caused by thrombosis in situ tends to develop over minutes to hours. In the context of acute stroke, imaging should be obtained.
