Abstract

In this article, we consider the management of patients in the first few hours and days following a stroke. In the UK, around 80% of first strokes are caused by cerebral infarction (ischaemic stroke), 10% by primary intracerebral haemorrhage (haemorrhagic stroke) and 5% by subarachnoid haemorrhage;1 in 5% of cases, the pathological type of the stroke is not clear.1 Among patients who have an ischaemic stroke, around 3-4% have a recurrence of stroke2–4 and 10% die,5 within the first 2-4 weeks; about 10% have a recurrence of stroke within 1 year.6 Among patients who have an intracerebral haemorrhage around 50% die within 30 days5 and around 60% within 1 year.1 Here we concentrate on the early management of adults with ischaemic or haemorrhagic stroke.