The Toolbox

Clinical Tools.

Bedside references for stroke clinicians — scales, eligibility checklists, imaging guides, and workflow tools built from the rhythm of an active stroke service.

Educational use only — always defer to your institutional protocols and clinical judgment.

§ 01  ·  Scales

Scoring & assessment.

Scale

NIHSS Pocket Guide

The 15-item National Institutes of Health Stroke Scale, with scoring conventions and the common pitfalls (item 9 vs item 10, dysarthria vs aphasia, sensory in aphasic patients).

PDF coming soon
Scale

mRS — modified Rankin

The functional outcome scale used in every major stroke trial. Useful at admission (baseline) and at 90-day follow-up.

PDF coming soon
Imaging

ASPECTS Visual Guide

The Alberta Stroke Program Early CT Score, region by region, with annotated normal and abnormal slices and the pitfalls in scoring under time pressure.

Walkthrough coming soon
§ 02  ·  Acute

Reperfusion & the door-to-needle clock.

Protocol

TNK / tPA Eligibility Checklist

Inclusion and exclusion criteria for IV thrombolysis, contemporary indications, dosing for both alteplase and tenecteplase, and the soft-call cases worth flagging to the attending.

PDF coming soon
Workflow

Door-to-Needle Bundle

The parallel-processing framework most certified stroke centers use to compress door-to-needle below 30 minutes — pre-notification, imaging-first, dosing-while-decision.

PDF coming soon
Decision tree

Thrombectomy Eligibility

A current decision map for endovascular therapy — early-window straightforward cases, late-window selection by CTP / MRI, and the expanding evidence for large-core thrombectomy.

Walkthrough coming soon
Targets

Acute BP Targets

Pre-thrombolysis, post-thrombolysis, post-thrombectomy, ICH, and SAH — the numbers and the rationale, with the agents most teams use.

Coming soon
§ 03  ·  Workup

Finding the mechanism.

Checklist

Stroke Workup Checklist

Standard etiology workup organized by TOAST mechanism — vessel imaging, cardiac monitoring, echo, labs — plus what to add for cryptogenic and young-patient strokes.

PDF coming soon
Reference

TOAST Classification

Mechanistic classification of ischemic stroke — large-artery atherosclerosis, cardioembolic, small-vessel, other determined, undetermined — with the workup needed to support each.

PDF coming soon
Reference

Young Stroke Workup

The additional workup for patients under 55 — hypercoagulable studies, dissection imaging, PFO bubble study, vasculopathy — in the order to send them.

Coming soon
§ 04  ·  Discharge

Closing the loop.

Checklist

Post-Stroke Discharge Checklist

Antithrombotic strategy, BP plan, statin, diabetes control, AFib decision (with ELAN / OPTIMAS timing), rehab disposition, follow-up clinic, and the warning-sign teaching every patient leaves with.

PDF coming soon
Algorithm

Antithrombotic Selection

Aspirin vs DAPT vs anticoagulation — choosing the right strategy by mechanism, with the duration and de-escalation plan.

Coming soon
Timing

AC Restart After Stroke / ICH

When to start (or restart) anticoagulation after ischemic stroke with AFib (ELAN, OPTIMAS) and after intracerebral hemorrhage — the current trial-anchored timing.

Coming soon