Recognition and management of threatened stroke

Completed stroke may often be prevented by early recognition and appropriate management of the stroke-threatened patient. About 80% of strokes are ischemic, the remainder hemorrhagic. Roughly half of ischemic strokes are heralded by transient ischemic attacks (TIA). The clinical picture of TIA depends upon which part of the brain is involved. The investigation of such patients is outlined, together with current approaches to medical and surgical therapy. Intracerebral hemorrhage rarely provides any advanced warning, but occasionally subarachnoid hemorrhage may be preceded by a warning leak, the clinical picture of which is described.