General Stroke Guidelines

• Definitive Stroke Guidelines (2009)
  American Heart Association
• Canadian Best Practice Recommendations for Stroke Care (2006)
  Canadian Stroke Network
• A supplement to the Canadian Stroke Strategy Canadian Best Practices Recommendations for Stroke Care (Update 2008)
  Canadian Stroke Network
• Stroke Consensus Statements (2008)
  7th Karolinska Stroke Update
• National Clinical Guidelines for Stroke, 2nd Edition (June 2004)
  Royal College of Physicians
  • Tables of Evidence, 2nd Edition
  • Concise Guide, 2nd Edition
  • Primary Care Concise Guidelines for Stroke, 2nd Edition
• Recognition and Treatment of Stroke in Children (2000)
  Brain Attack Coalition - Ad Hoc Committee on in Children
• American Heart Association Prevention Conference IV: Prevention and Rehabilitation of Stroke
  Executive Summary (see individual sections below)
  Journal link: Circulation (log in may be required)
• Recognition and Treatment of Stroke in Children (Updated 2005)
  The Child Neurology Society Ad Hoc Committee on Stroke in Children.  (National Institute for Neurologic Disorders and Stroke)

Top

Acute Stroke Management

• Indications for the Performance of Intracranial Endovascular Neurointerventional Procedures (2009)  American Heart Association Scientific Statement Journal link: Circulation
• Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage Stroke (2009)  American Heart Association Scientific Statement
  Journal link: Stroke
• Partnering to Reduce Risks and Improve Cardiovascular Outcomes (2009)  American Heart Association Scientific Statement
  Journal link: Circulation
• The American Heart Association's 2008 Statement of Principles for Healthcare Reform (2008)  American Heart Association Scientific Statement Journal link: Circulation
• AHA/ASA Policy Statement: Implementation Strategies for Emergency Medical Services Within Stroke Systems of Care (2007)  American Heart Association Scientific Statement Journal link: Stroke
• Guidelines for the Early Management of Patients With Ischemic Stroke(2007)  American Heart Association Scientific Statement Journal link: Stroke
• Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults (2007 Update) American Heart Association Journal link: Circulation
• Reducing Delay in Seeking Treatment by Patients With Acute Coronary Syndrome and Stroke (2006)
  A Scientific Statement From the American Heart Association Council on Cardiovascular Nursing and Stroke Council
  
• Stroke Management (2004)
  Karolinska Stroke Update
• Blood Pressure Control and Secondary Stroke Prevention (2004)
  Karolinska Stroke Update
• Reperfusion in Acute Occlusive Stroke (2004)
  Karolinska Stroke Update
• Antiplatelet Therapy (2004)
  Karolinska Stroke Update
• Prophylaxis and Treatment - Information for doctors in hospitals and practice - Update 2003/2004
  European Stroke Initiative
• European Stroke Initiative Recommendations for Stroke Management - Update 2003
• Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke (2002)
  American Heart Association Scientific Statement
  Journal link: Stroke (log in may be required)
• Use of Intravenous tPA for the Management of Acute Stroke in the Emergency Department (2002)
  American College of Emergency Physicians
• Thrombolysis for Acute Ischemic Stroke (2007)
  Thrombosis Interest Group of Canada
• Brain Attack Coalition - Acute Stroke Toolbox
  Tools for health care professionals developing systems to enable the rapid diagnosis and treatment of acute stroke.  Includes patient management guidelines and pathways.
• Guide to Anticoagulant Therapy: Heparin (2001)
  American Heart Association Scientific Statement
  Journal link: Circulation (log in may be required)
• Recommendations for clinical trial evaluation of acute stroke therapies (2001)
  Stroke Therapy Academic Industry Roundtable II (STAIR-II).
  Journal link: Stroke (log in may be required)
• Thrombolysis for Acute Ischemic Stroke (2001)
  Consensus Statement of the 3rd Karolinska Stroke Update
  Journal link: Stroke (log in may be required)
• Antithrombotic and thrombolytic therapy for ischemic stroke (2001)
  From: Sixth ACCP Consensus Conference on Antithrombotic Therapy
  Journal link: Chest (log in may be required)
• Addendum to the Supplement to the Guidelines for the Management of Transient Ischemic Attacks (2000)
  American Heart Association Scientific Statement
  Journal link: Stroke
• AHA/ACC Conference Proceedings: Measuring and Improving Quality of Care (2000)
  American Heart Association Scientific Statement
  Journal link: Circulation
• Acute Treatment of Ischemic Stroke (2000)
  European Stroke Initiative  ( version)
• Recommendations for the Management of Patients With Unruptured Intracranial Aneurysms (2000)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Consensus Conference on Stroke Treatment and Service Delivery (2000)
  Royal College of Physicians of Edinburgh
• Supplement to the Guidelines for the Management of Transient Ischemic Attacks (1999)  
  American Heart Association Scientific Statement
  Journal link: Stroke
• Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (1999)  
  American Heart Association Scientific Statement
  Journal link: Stroke (log in may be required)
• The American Heart Association Stroke Outcome Classification (1998)  
  Executive Summary
  American Heart Association Scientific Statement
  Journal link: Circulation
• The American Heart Association Stroke Outcome Classification (1998)  
  Full Text
  American Heart Association Scientific Statement
  Journal link: Stroke
• Canadian Guidelines for Intravenous Thrombolytic Treatment in Acute Stroke (1998)
  A Consensus Statement of The Canadian Stroke Consortium
• Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning (2002 - 5) 
  Scottish Intercollegiate Guidelines Network (SIGN)
  (Quick Reference Guide )
• Practice Guidelines for the Use of Imaging in Transient Ischemic Attacks and Acute Stroke (1997)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Acute Stroke Treatment Guidelines (1997)
  National Institute for Neurologic Disorders and Stroke, NIH. 
  (Executive Summary)
• American Heart Association Prevention Conference IV: Prevention and Rehabilitation of Stroke: Acute Interventions (1997)
  Executive Summary
  Journal link: Circulation (log in may be required)
• Thrombolytic Therapy for Acute Ischemic Stroke (1996)
  American Academy of Neurology Practice Advisory
• Guidelines for Thrombolytic Therapy for Acute Stroke: A Supplement to the Guidelines for the Management of Patients With Acute Ischemic Stroke (1996)
  American Heart Association Medical/Scientific Statement
  Journal link: Circulation (log in may be required)
• Guidelines for the Management of Transient Ischemic Attacks (1994)
  American Heart Association Medical/Scientific Statement
• Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (1994)
  American Heart Association Medical/Scientific Statement

Top

Stroke Prevention

• Update to the AHA/ASA Recommendations for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack (2008)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke
• Primary Prevention of Ischemic Stroke (2006)
  A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group
• Digest - Primary Prevention of Ischemic Stroke (2006) American Heart Association Medical/Scientific Statement
  Journal link: Stroke
• Risk estimation and the prevention of cardiovascular disease
  Full guideline / Patient Guideline
  Scottish Intercollegiate Guidelines Network (SIGN)
• Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack (2006)
  Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke
  
• Carotid Endarterectomy and Angioplasty (2004)
  Karolinska Stroke Update
• Statins and Thrombin Inhibitors (2004)
  Karolinska Stroke Update
• Determining the Appropriateness of Selected Surgical and Medical Management Options in Recurrent Stroke Prevention: A Guideline for Primary Care Physicians (2004)
  National Stroke Association Work Group on Recurrent Stroke Prevention
• Recurrent Stroke in Patients with Patent Foramen Ovale and Atrial Septal Aneurysm (2004)
  American Academy of Neurology practice statement
• Prevention of Ischemic Stroke (2005)
  Thrombosis Interest Group of Canada
• The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003)
  US National Heart, Lung, and Blood Institute, NIH
  (reference card)
• Primary Prevention of Hypertension: Clinical and Public Health Advisory from the National High Blood Pressure Education Program (2003)
  US National Heart, Lung, and Blood Institute, NIH
• Role of Warfarin in Primary or Secondary Stroke Prevention (2002)
  Stroke Council of the American Heart Association
• AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update (2002)
  American Heart Association
  Journal link: Circulation (log in may be required)
• Recommendations for the Endovascular Treatment of Intracranial Aneurysms (2002)  
  American Heart Association Scientific Statement
• Stroke Prevention in Atrial Fibrillation (2007)
  Thrombosis Interest Group of Canada
• Recommendations for the Management of Intracranial Arteriovenous Malformations (2001)
  American Heart Association Scientific Statement
  Journal link: Stroke (log in may be required)
• ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation (2006) ( available)
  American College of Cardiology / American Heart Association - Executive Summary
• Stanol/Sterol Ester-Containing Foods and Blood Cholesterol Levels (2001)
  American Heart Association Science Advisory
  Journal link: Circulation (log in may be required)
• ATP III At-A-Glance: Quick Desk Reference (2001) 
  National Heart, Lung and Blood Institute's updated cholesterol guidelines.
• Primary Prevention of Ischemic Stroke (2001) 
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Antithrombotic therapy in atrial fibrillation (2001)
  From: Sixth ACCP Consensus Conference on Antithrombotic Therapy
  Journal links: Chest (log in may be required)
• Antithrombotic and thrombolytic therapy for ischemic stroke (2001)
  From: Sixth ACCP Consensus Conference on Antithrombotic Therapy
  Journal links: Chest (log in may be required)
• Screening and Management of Hyperhomocysteinemia for the Prevention of Coronary Artery Disease Events (2000)
  Canadian Task Force on Preventitive Health Care
• Treatment guidelines--primary and secondary prevention of stroke (2000) Medical Commission of the German Medical Society.  [Article in German]
• Risk factors and stroke prevention (2000)
  European Stroke Initiative ( version)
• Recommendations for the Management of Patients With Unruptured Intracranial Aneurysms (2000)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Consensus Conference on Stroke Treatment and Service Delivery (2000)
  Royal College of Physicians of Edinburgh
• Preventing Ischemic Stroke in Patients With Prior Stroke and Transient Ischemic Attack (1999)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Italian Guidelines for Stroke Prevention (1999)
  Stroke Prevention and Educational Awareness Diffusion (SPREAD) Collaboration
• Prevention of a first stroke (1999)
  A review of guidelines and a multidisciplinary consensus statement from the National Stroke Association
  Journal link: JAMA (log in may be required)
• Guidelines for Carotid Endarterectomy (1998)
  American Heart Association Medical/Scientific Statement
  Journal link: Circulation (log in may be required)
• Carotid Stenting and Angioplasty (1998)
  American Heart Association Medical/Scientific Statement
  Journal link: Circulation (log in may be required)
• Stroke Prevention in Patients with Nonvalvular Atrial Fibrillation (1998)
  American Academy of Neurology Practice Parameter
  
• Consensus Against Both Endarterectomy and Routine Screening for Asymptomatic Carotid Artery Stenosis (1997)
  Canadian Stroke Consortium
• Practice Guidelines for the Use of Imaging in Transient Ischemic Attacks and Acute Stroke (1997)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Cigarette Smoking, Cardiovascular Disease, and Stroke (1997)
  American Heart Association Medical/Scientific Statement
  Journal link: Circulation (log in may be required)
• American Heart Association Prevention Conference IV: Prevention and Rehabilitation of Stroke: Rehabilitation (1997)
  Executive Summary
  Journal link: Circulation (log in may be required)
• Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (1997)
  US National Heart, Lung, and Blood Institute, NIH 
  (Pocket Guide)
• Management of Patients with Atrial Fibrillation (1996)
  American Heart Association Medical/Scientific Statement
  Journal link: Circulation (log in may be required)
• Stroke Prevention: Recommendations (1995)
  The Secondary and Tertiary Prevention of Stroke Patient Outcomes Research Team (PORT), Agency for Health Care Policy and Research (AHCPR)
• Asymptomatic Carotid Disease (1994)
  Canadian Task Force on Preventive Health Care

Top

Recovery

• Management of Adult Stroke Rehabilitation Care: A Clinical Practice Guideline (2005)
  AHA/ASA-Endorsed Practice Guidelines
• Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care Executive Summary (2005)
  
• Physical Activity and Exercise Recommendations for Stroke Survivors (2004)
  AHA Scientific Statement
  Journal link: Circulation (log in may be required)
• Statins After Ischemic Stroke and Transient Ischemic Attack (2004)
  AHA/ASA Scientific Advisory
  Journal link: Stroke (log in may be required)
• Management of Stroke Rehabilitation Care (2003)
  Clinical Practice Guideline Working Group, Veterans Health Administration
• National Sentinal Stroke Audit Report 2004 (Concise Report)
  Royal College of Physicians
  (Concise Guide)
• Management of dementia (an evidence-based review) (2001)
  Report of the Quality Standards Subcommittee of the American Academy of Neurology
  Also: Summary Version for Physicians, and Summary Version for Families
• Diagnosis of dementia (an evidence-based review) (2001)
  Report of the Quality Standards Subcommittee of the American Academy of Neurology
• Care after Stroke (2000)  (for patients and caregivers)
  Royal College of Physicians
• Consensus Conference on Stroke Treatment and Service Delivery (2000)
  Royal College of Physicians of Edinburgh
• Management of patients with stroke part IV: Rehabilitation, prevention and management of complications, and discharge planning (1998)
  Scottish Intercollegiate Guidelines Network (SIGN)
• American Heart Association Prevention Conference IV: Prevention and Rehabilitation of Stroke: Rehabilitation (1997)
  Journal link: Stroke (log in may be required)
• Management of patients with stroke: Rehabilitation, prevention and management of Complications, and discharge planning: A national clinical guideline (2002)
  Scottish Intercollegiate Guidelines Network (SIGN 64)
  
• Post-Stroke Rehabilitation (Clinical Guide #16) (1995)  
  Agency for Health Care Policy and Research (AHCPR)
• Post-Stroke Rehabilitation (Quick Reference Guide #16) (1995)  
  Agency for Health Care Policy and Research (AHCPR)

Top

Stroke Care Organization

• Recommendations for Comprehensive Stroke Centers (2005)
  A Consensus Statement From the Brain Attack Coalition
  Journal link: Stroke (log in may be required)
• Recommendations for the Establishment of Stroke Systems of Care (2005)
  American Stroke Association’s Task Force on the Development of Stroke Systems
  Journal link: Stroke (log in may be required)
• Recommendations for Improving the Quality of Care Through Stroke Centers and Systems: An Examination of Stroke Center Identification Options (2002)
  American Stroke Association Multidisciplinary Consensus Recommendations
  Journal link: Stroke (log in may be required)
• Organization of Stroke Care: Education, Stroke Units and Rehabilitation (2000)
  European Stroke Initiative  ( version)
• Recommendations for the creation of neurovascular units (2000)
  French Neurovascular Society (Societe Francaise Neuro-Vasculaire)
  [Article in French]
• Recommendations for the use of intravenous thrombolytic therapy in cerebrovascular ischemic accident (2000)
  French Society of Neurovascular Disorders
• Recommendations for the Establishment of Primary Stroke Centers (2000)
  Brain Attack Coalition ( version)
• Consensus Conference on Stroke Treatment and Service Delivery (2000)
  Royal College of Physicians of Edinburgh
• Stroke Center Recommendations (1999)
  National Stroke Association
• Acute Stroke Treatment Guidelines (1997)
  National Institute for Neurologic Disorders and Stroke, NIH.
  (Executive Summary)

Top

Diagnosis

• Investigation for Suspected Hypercoagulable States (Thrombophilias) (2006)
  Thrombosis Interest Group of Canada
• Coronary Risk Evaluation in Patients With Transient Ischemic Attack and Ischemic Stroke (2003)
  AHA/ASA Scientific Statement
  Journal link: Circulation (log in may be required)
• Screening and Treatment of Hyperhomocysteinemia (2002)
  Thrombosis Interest Group of Canada
• ACR Standard for the Performance of Computed Tomography (CT) in the Extracranial Head and Neck in Adults and Children (2001)
  American College of Radiology
• Magnetic Resonance Angiography- Update on Applications for Extracranial Arteries (1999)
  American Heart Association Scientific Statement
  Journal link: Circulation (log in may be required)
• Use of Ambulatory Electrocardiography for the Detection of Paroxysmal Atrial Fibrillation in Patients with Stroke (1999)
  Canadian Task Force on Preventive Health Care
• Echocardiography for the Detection of a Cardiac Source of Embolus in Patients with Stroke (1999)
  Journal link: Canadian Medical Association Journal (log in may be required)
• ACR Standard for the Performance of Computed Tomography (CT) in Neuroradiologic Imaging of Adults and Children (1998)
  American College of Radiology
• ACC/AHA Guidelines for the Clinical Application of Echocardiography (1997)
  A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines
  Journal link: Circulation (log in may be required)
• Practice Guidelines for the Use of Imaging in Transient Ischemic Attacks and Acute Stroke (1997)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Applications of transcranial doppler ultrasound in neuroanesthesia
  Stephan Strebel, Department of Anaesthesia, University of Basel, Switzerland. Includes detailed technical description of TCD and use in anesthesia.

Top

Imaging

• Practice Guidelines for the Use of Imaging in Transient Ischemic Atacks and Acute Stroke (1997)
  American Heart Association
• The Impact of Imaging on Stroke Treatment and Clinical Outcome (2004)
  Karolinska Stroke Update
• Guidelines and Recommendations for Perfusion Imaging in Cerebral Ischemia (2003)
  American Heart Association Scientific Statement
• American College of Radiology Standards
  • Practice Guideline for the Performance and Interpretation of Magnetic Resonance Imaging (MRI) of the Brain (2006) \
  • ACR Practice Guideline for the Performance of Magnetic Resonance Imaging of the Head and Neck (Amended 2006)
    
  • ACR Practice Guideline for Performance of Computed Tomography (CT) of the Brain (2006)
  • ACR Practice Guideline for the Performance and Interpretation of Computed Tomography (CT) of the Head and Neck in Adults and Children (2006)
  • Practice Guideline for the Performance of Diagnostic Arteriography in Adults
    
  • ACR Practice Guideline for the Performance of Transcranial Doppler Ultrasound for Adults and Children (Collaborative with AIUM) (2007)
    
  • ACR Practice Guideline for the Performance of Cerebral Scintigraphy for Brain Death (Amended 2006)
  • ACR Practice Guideline for Performing and Interpreting Magnetic Resonance Imaging (MRI) (2006)
  • ACR Practice Guideline for the Performance of Pediatric and Adult Neurovascular Magnetic Resonance Angiography (MRA) (Amended 2006)
  • APR Practice Guideline for the Performance of Single Photo Emission Computed Tomography (SPECT) Brain Perfusion Imaging (Amended 2006)
  • Standard for the Performance of Diagnostic Cervicocerebral Angiography in Adults (Amended 2006)
• Recommendations for the Endovascular Treatment of Intracranial Aneurysms (2002)  
  American Heart Association Scientific Statement
• Society of Cardiovascular & Interventional Radiology Clinical Practice Guidelines
• Use Of Ambulatory Electrocardiography For The Detection Of Paroxysmal Atrial Fibrillation In Patients With Stroke (2000)
  Canadian Task Force on Preventive Health Care
• Echocardiography for the detection of a cardiac source of embolus in patients with stroke (1999)
  Canadian Task Force on Preventive Health Care
• Carotid Stenting and Angioplasty (1998) 
  American Heart Association Medical/Scientific Statement
  Journal link: Circulation (log in may be required)
• American College of Cardiology
  Searchable database of Practice Statements
• Practice Guidelines for the Use of Imaging in Transient Ischemic Attacks and Acute Stroke (1997)
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke (log in may be required)
• Echocardiographic Identification of Cardiovascular Sources of Emboli To Guide Clinical Management of Stroke: A Cost-Effectiveness Analysis (1997)
  Annals of Internal Medicine 1 November 1997. 127:775-787.
• Cost-Effectiveness of Screening for Carotid Stenosis in Asymptomatic Persons (1997)
  Annals of Internal Medicine 1 March 1997. 126:337-346.
• Magnetic Resonance Angiography: Vascular and Flow Imaging (1994)
  Agency for Health Care Policy and Research

Top

Pediatric Stroke

• Management of Stroke in Infants and Children
  American Heart Association Medical/Scientific Statement
  Journal link: Stroke
• Recognition and Treatment of Stroke in Children
  Child Neurology Society Ad Hoc Committee on Stroke in Children
  Brain Attack Coalition
• Stroke in Childhood Clinical Guidelines (2004)
  Roual College of Physicians ( available)

Top

Sources for Stroke Guidelines and Consensus Statements

The Cochrane Database of Systematic Reviews (CDSR) - Stroke Group
Abstracts of > 40 systematic, updated reviews of various aspects of stroke therapy. Full reviews are available by personal or institutional subscription. Search Medline for Cochrane stroke review abstracts.

American Heart Association Medical and Scientific Statements
Growing list of detailed consensus statements on all aspects of cardiovascular disease and stroke. Stroke guidelines are listed individually below. Guidelines for Palm and other handheld devices are available from Mobile Medica.

American Academy of Neurology - Guideline Statements
Large listing of guidelines, advisories and parameters.

US National Heart, Lung, and Blood Institute (NIH) - Cardiovascular Information for Health Professionals
Current guidelines and interactive web sites for primary prevention treatment of hypertension, obesity and cholesterol.

National Guideline Clearinghouse
Sponsored by the US Agency for Healthcare Research and Quality

European Stroke Initiative (EUSI)
Recommendations for stroke management.

American College of Cardiology
Practice guidelines and quality standards -- sorted by topic.

Systematic Reviews & Recommendations of Conditions Affecting Primarily the Elderly
Canadian Task Force on Preventive Health Care

Canadian Medical Association
Evidence-Based Resource Sheets and Tools
(log in may be required)

Mobile Medica - Apprisor
Downloadable guidelines from the American Heart Association for Palm and other handheld devices. Includes a full selection of stroke management and prevention recommendations.

Top

This page last updated: April 21, 2009 1:11 PM