Applying the South African 2026 stroke guidelines

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This clinical practice review of stroke assessment, distinguishing between ischaemic, haemorrhagic, TIAs or stroke mimics, helps to ensure appropriate time-critical action in emergency care

Learning objectives

You will learn:

  • Identify stroke as a medical emergency and initiate rapid assessment and referral pathways
  • Distinguish between ischaemic stroke, haemorrhagic stroke and transient ischaemic attack, including how to recognise common stroke mimics
  • Perform initial stroke assessment using FAST/BE-FAST and ABC principles, including exclusion of hypoglycaemia
  • Outline the indications, time window (≤4.5 hours) and contraindications to thrombolysis (alteplase) in acute ischaemic stroke
  • Select appropriate imaging (computed tomography/magnetic resonance imaging [CT/MRI]) and apply National Institutes of Health Stroke Scale scoring, while recognising key limitations in clinical practice.

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