Sudden weakness and speech disturbance: acute ischaemic stroke pathway

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Educational simulation. Not for real patient care and not a substitute for supervised training. Always follow local protocols.

What you will practise

Recognise the focal deficits of acute stroke and record the time the patient was last known to be well.
Prioritise immediate glucose measurement and non-contrast brain imaging to separate ischaemic stroke, haemorrhage and mimics.
Explain why imaging must precede thrombolysis and anticoagulant or antiplatelet decisions.
Describe the principle of reperfusion therapy: intravenous thrombolysis and mechanical thrombectomy for large vessel occlusion.
Recognise and manage a suspected intracranial haemorrhage after thrombolysis.
Outline stroke unit care, swallow screening, cause search and secondary prevention.

Which vessel of the circle of Willis connects the internal carotid circulation with the posterior cerebral artery?
A right-handed patient has sudden right face and arm weakness greater than leg weakness, right-sided sensory loss and non-fluent speech. Which artery is most likely occluded?
What is the mechanism of action of warfarin, and which agent reverses its effect over hours?
Why does a low dose of aspirin have a prolonged antiplatelet effect lasting about the lifespan of platelets?
Which is the most common underlying cause of spontaneous (non-traumatic) intracerebral haemorrhage in the basal ganglia of an adult?