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Updated: Sep 29, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Consent Issues in the Management of Acute Ischemic Stroke: AAN Position Statement
Justin A Sattin1, Winston Chiong2, Richard J Bonnie2
1From the Department of Neurology (J.A.S.), University of Wisconsin, Madison; Department of Neurology (W.C.), University of California San Francisco; Institute of Law, Psychiatry and Public Policy (R.J.B.), University of Virginia School of Law, Charlottesville; Department of Anesthesiology and Critical Care Medicine (M.P.K.), University of Pennsylvania, Philadelphia; and Department of Neurology (J.A.R.), Lahey Hospital and Medical Center, Burlington, MA. sattin@neurology.wisc.edu.
None:
This position statement briefly reviews the principle of informed consent, the elements of decisional capacity, and how acute stroke may affect this capacity. It further reviews the role of surrogate decision-making, including advance directives, next of kin, physician orders for life-sustaining treatment, and guardianship. In some cases of acute stroke in which the patient lacks decisional capacity and no advance directives or surrogates are available, consent to treatment may be presumed. The document describes the rationale for this position and various considerations regarding its application to IV thrombolysis, neuroendovascular intervention, decompressive craniectomy, and pediatric stroke. The document also reviews consent issues in acute stroke research.
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