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. 2026 May 7;11(5):aakag044. doi: 10.1093/esj/aakag044

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© The Author(s) 2026. Published by Oxford University Press on behalf of the European Stroke Organisation.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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The flowchart outlines clinical monitoring after stroke admission, daily assessment for suspected SAP within 7 days, application of diagnostic criteria (e.g. PISCES), and subsequent decisions to initiate treatment or pursue further evaluation if criteria are not met. — Proposed algorithm for SAP diagnosis and treatment decision-making.