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Emergency Medicine Journal 2008;25:735-739; doi:10.1136/emj.2008.058206
© 2008 BMJ Publishing Group Ltd and the College of Emergency Medicine.

ORIGINAL ARTICLES

Knowledge of signs, treatment and need for urgent management in patients presenting with an acute ischaemic stroke or transient ischaemic attack: a prospective study

L G Stead1, L Vaidyanathan1, M F Bellolio1, R Kashyap1, A Bhagra1, R M Gilmore1, W W Decker1, S Enduri1, S Suravaram1, S Mishra1, D Nash1, H M Wood1, A S Yassa1, A M Hoff1 and R D Brown2

1 Department of Emergency Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
2 Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Correspondence to:
Dr L G Stead, Mayo Clinic, Generose G410, 200 First Street, Rochester, MN 55905, USA; stead.latha{at}mayo.edu

Objective: To assess stroke awareness among patients presenting to the emergency department with an acute ischaemic stroke or transient ischaemic attack (TIA).

Methods: A consecutive cohort of patients presenting with a cerebrovascular event was prospectively enrolled over a 15-month period and questionnaires were administered. If the patient was unable to respond to the questions or answer the questionnaire, it was administered to the primary caregiver. Comprehension of having a cerebrovascular event, reason for delay in presentation, mode of arrival and knowledge of treatment modalities were determined.

Results: Only 42% of 400 patients thought they were having a stroke or TIA. The median time to presentation was 3.4 h. Delayed presentation was almost equal in men and women. When asked about onset, 19.4% thought that a stroke came on gradually and only 51.9% thought immediate presentation was crucial. 20.8% of patients had heard of thrombolysis.

Conclusion: Community knowledge of ischaemic stroke needs to be enhanced so that individuals present earlier, leading to timely management.


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