Vera arrives at the thrombectomy centre and is taken straight to the Radiology dept (not ED since she has already been through the first part of the pathway at the spoke hospital). She is met by the team comprising the INR, anaesthetist and hub stroke nurse. The paramedics give a verbal handover.
- A full NIHSS is performed and recorded. Sometimes changes in the patients condition or delays in transfers will mean that the patient needs further brain imaging.
Indicate which of the following statements are True or False.
- If Vera’s NIHSS increased by more than 4 points during transfer further brain imaging may be useful on arrival at the hub – True – it may show a bleed or large infarct so she would not benefit from thrombectomy.
- If the Vera’s NIHSS reduced to less than 4 during transfer further brain imaging may be useful on arrival at the hub – True – it may show that her large artery is no longer blocked so she would not benefit from thrombectomy.
- If Vera’s transfer was slow, and she arrives at the hub more than six hours after stroke onset further brain imaging may be required – True – it may help determine whether she still has salvageable brain tissue which might be saved by thrombectomy.
- Patients should always have repeat brain imaging at the hub before proceeding to thrombectomy – False – this takes time, will delay reperfusion and reduce the chances of a good recovery. Repeat imaging is only required if the patients condition has changed or it is more than 6 hours after symptom onset.
