3.10 Acute stroke care

Many patients presenting with acute neurological deficits secondary to vascular disease will have other problems requiring attention during and after their initial diagnosis (Section 3.4 Diagnosis and treatment of acute stroke – imaging) and the pathology-specific treatments described in Sections 3.5 Management of ischaemic stroke and 3.6 Management of intracerebral haemorrhage. Three-quarters of patients with acute stroke admitted to hospital in the UK have at least one co-morbidity, and one in ten have at least three (Intercollegiate Stroke Working Party, 2016). Patients need specialist care on a stroke unit focused initially on preserving life, limiting brain damage and preventing complications before rehabilitation can begin in earnest. Patients with stroke often have significant disturbances of physiological homeostasis with raised temperature, raised blood glucose, hypoxia, etc. During the first week, 5% of patients with acute stroke develop urinary sepsis, and 9% require antibiotic treatment for pneumonia (Intercollegiate Stroke Working Party, 2016). [2016]