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Acute Stroke Care Unit

Inclusion/Exclusion Criteria

Admission Criteria:

  1. Age ≥ 18
  2. Ischemic stroke s/p IV tPA
  3. Acute stroke symptom onset < 24 hours

Exclusion Criteria:

  1. NIHSS score > 25
  2. Complete MCA territory infarction
  3. Acute Basilar Artery thrombosis
  4. Large cerebellar infarction
  5. Patients requiring or at high risk of requiring osmotic therapy for cerebral edema
    • 3% NaCl up to 30 cc/hr for the treatment of hyponatremia is permissible
  6. Patients who receive IV tPA for an in-house stroke
  7. Evidence of early hemorrhagic conversion of ischemic infarct s/p IV tPA
  8. Presence of ICH, IVH, SAH, SDH, EDH on any imaging modality
  9. Hemodynamic instability:
    • Patient requiring continuous IV drip for BP or HR control
    • Patient requiring continuous IV drip for BP augmentation for persistent hypotension despite IVF, for BP-dependent exam, or for underperfused territory
  10. Presence of Acute MI
  11. Patient at risk of impending respiratory failure:
    • impaired consciousness, evidence of aspiration event, unable to manage secretions, frequent suction requirements (> q 2 hours)
  12. Patient s/p intra-arterial procedure
ASCU Workflow

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ASCU Workflow Algorithm

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In the News

The MGH Neurology Department placed 4th in US News Neurology / NeuroSurgery rankings for 2013-14.

Educational Video

Still from the Stroke Evaluation simulation

This video simulation of an Emergency stroke evaluation illustrates the care of patients with acute stroke by the MGH Acute Stroke team.