West Chester Stroke/TIA Admission Criteria

Inclusion Criteria

Acute onset of focal neurological dysfunction

  • Post-TNK patients admitted to WCH ICU with post-TNK order set
  • Stable non-TNK patients admitted to Acute Care Neurology Cohort Unit
Exclusion Criteria (Transfer to UCMC)*
  • Large Vessel Occlusion and candidate for endovascular therapy (EVT)
  • Large Vessel Occlusion with low NIHSS but concern for decompensation within 24 hours and need for EVT
  • Basilar Artery Occlusion
  • Acute Cervical or Vertebral Artery Dissection or unstable plaque with fluctuating symptoms and possible need for Neuro-intervention
  • Critical stenosis with fluctuating symptoms and possible need for Neuro-intervention
  • Large Vessel Stroke with concern for malignant cerebral edema and need for possible hemi-craniotomy
  • Large Posterior Circulation Stroke with concern for malignant cerebral edema and possible need for sub-occipital craniectomy
  • Acute Stroke with concern for subclinical status epilepticus with no EEG tech available
  • WCH Neurology discretion
*Decision to transfer should be made in collaboration with the WC Primary Providers (ED, IM, Neuro), UC Stroke Team, Neuro-IR, and Neurosurgery when clinically appropriate
Equivocal (Discussion with Stroke Team/NIR Required)
  • RCVS
  • Venous Sinus Thrombosis
  • Middle meningeal artery embolization for subdural hematoma (may sometimes present with mimics)**
  • TIA or small stroke with carotid stenosis
**Though not a “stroke” there can be significant overlap in consultations for such patients with symptoms