Assessments to consider when diagnosing acute ischemic stroke

Explore key evaluations for patients with AIS

When assessing AIS, the following assessments should be considered

Patient History:

Recommended Diagnostic Tests:

Stroke Severity:

Disability Assessment:

Do you conduct an individualized disability assessment for all patients with AIS?

aThe AHA/ASA recommends brain imaging (noncontrast CT in most cases) and assessment of blood glucose precede the initiation of IV alteplase in all patients. Although it is desirable to know the results of the other tests before administering Activase, fibrinolytic therapy should not be delayed while awaiting those results unless: 1) there is clinical suspicion of a bleeding abnormality or thrombocytopenia; 2) the patient has received heparin or warfarin; or 3) the patient has received other anticoagulants (direct thrombin inhibitors or direct factor Xa inhibitors). 2

bIf patient transport to a mechanical thrombectomy-capable facility is required, notify that facility’s neurointerventionalist and place interfacility patient transport on standby. 2,3


  • More than 1 in 7 ischemic strokes may be misdiagnosed 7,8
  • 37% of posterior strokes were initially misdiagnosed, compared with 16% of anterior strokes 7