Table 3.

Stroke

Stroke diagnostic criteria

Rapid onset of a focal or global neurological deficit with at least one of the following: change in level of consciousness, hemiplegia, hemiparesis, numbness or sensory loss affecting one side of the body, dysphasia or aphasia, haemianopia, amaurosis fugax, or other neurological signs or symptoms consistent with stroke

Duration of a focal or global neurological deficit ≥24 h; OR < 24 h, if therapeutic intervention(s) were performed (e.g. thrombolytic therapy or intracranial angioplasty); OR available neuroimaging documents a new haemorrhage or infarct; OR the neurological deficit results in death

No other readily identifiable non-stroke cause for the clinical presentation (e.g. brain tumour, trauma, infection, hypoglycaemia, peripheral lesion, pharmacological influences)a

Confirmation of the diagnosis by at least one of the following:

Neurology or neurosurgical specialist

Neuroimaging procedure (MR or CT scan or cerebral angiography)

Lumbar puncture (i.e. spinal fluid analysis diagnostic of intracranial haemorrhage)

Stroke definitions

Transient ischaemic attack:

New focal neurological deficit with rapid symptom resolution (usually 1–2 h), always within 24 h

Neuroimaging without tissue injury

Stroke: (diagnosis as above, preferably with positive neuroimaging study)

Minor—Modified Rankin score <2 at 30 and 90 daysb

Major—Modified Rankin score ≥2 at 30 and 90 days

^aPatients with non-focal global encephalopathy will not be reported as a stroke without unequivocal evidence based upon neuroimaging studies.

^bModified Rankin Score assessments should be made by qualified individuals according to a certification process. If there is discordance between the 30 and 90 day Modified Rankin Scores, a final determination of major vs. minor stroke will be adjudicated by the neurology members of the clinical events committee.