Inclusion Criteria- Adults over 18 years ( the age for adults may vary in different countries)
- Have a clinical diagnosis of acute stroke (i.e. with a persistent neurological deficit on presentation)
- Presentation to hospital including in-hospital event and hospital transfers , with a stroke
Exclusion Criteria- Transient ischaemic attack (TIA) (i.e. symptoms fully resolved upon presentation).
- Definite clinical contraindication or indication to either sitting up head position or lying flat head position.
- Significant medical condition that takes priority in care and where adherence to the randomised head position is not possible on another ward/department of the hospital.
- Immediate transfer from the Emergency Department (ED) or admission, to another ward for medical treatment (e.g. for haemodialysis) or surgery (e.g. carotid endarterectomy, haematoma evacuation) where adherence to the randomised head position is not possible