Current Stroke Guidelines

Question 1

Which guideline is used for acute stroke and TIA diagnosis and initial management?

Answer 1

NICE (2022) – Stroke and transient ischaemic attack: diagnosis and initial management.

Question 2

What stage of care does NICE (2022) focus on?

Answer 2

The hyperacute and acute phase of stroke and TIA.

Question 3

What does NICE (2022) guide clinicians on?

Answer 3

Rapid recognition, urgent imaging, differentiation of stroke type, thrombolysis/thrombectomy decisions, and early medical management.

Question 4

What imaging is recommended first-line in suspected acute stroke according to NICE (2022)?

Answer 4

Non-contrast CT to exclude haemorrhage.

Question 5

What treatments are guided by NICE (2022) in ischaemic stroke?

Answer 5

Thrombolysis (within 4.5 hours if eligible) and thrombectomy (within appropriate time windows).

Question 6

Which guideline focuses on rehabilitation after stroke?

Answer 6

NICE (2023) – Stroke rehabilitation in adults.

Question 7

What stage of stroke care does NICE (2023) address?

Answer 7

The rehabilitation and recovery phase.

Question 8

What does NICE (2023) emphasise for physiotherapy?

Answer 8

Early, intensive, task-specific rehabilitation to improve function and independence.

Question 9

What physiotherapy interventions are supported by NICE (2023)?

Answer 9

Functional task practice, mobility training, balance work, strengthening, gait training, and spasticity management.

Question 10

How does NICE (2023) view the MDT?

Answer 10

Stroke rehabilitation should be MDT-led, involving physio, OT, SALT, psychology, nursing, and medical staff.

Question 11

Which guideline covers the entire stroke pathway from prevention to long-term care?

Answer 11

RCP National Clinical Guideline for Stroke (2023).

Question 12

What makes the RCP guideline different from NICE guidelines?

Answer 12

It provides whole-pathway and service-level standards, not just condition-specific guidance.

Question 13

What does the RCP guideline say about stroke services?

Answer 13

Stroke care should be delivered in specialist stroke units with coordinated MDT input.

Question 14

How does the RCP guideline support rehabilitation?

Answer 14

By setting standards for rehabilitation intensity, frequency, quality, and outcomes.

Question 15

How do the guidelines link together in practice?

Answer 15

NICE (2022): acute diagnosis & medical management; NICE (2023): rehabilitation & therapy; RCP (2023): whole stroke pathway & service standards.