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Treatment of the unknown patient: insights from acute stroke
  1. Simon M Bell1,2,
  2. Dilraj Sokhi3,
  3. Tom Hughes4,
  4. Marc S Randall5
  1. 1Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  2. 2Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
  3. 3Department of Neurology, Aga Khan University Hospital, Nairobi, Kenya
  4. 4Department of Neurology, University Hospital of Wales, Cardiff, Wales, UK
  5. 5Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds, UK
  1. Correspondence to Dr Simon M Bell, Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK; Simonbell{at}


When an unidentified patient who cannot communicate presents with symptoms and signs suggesting an acute stroke, the decision to thrombolyse is a particular challenge. In a time-pressured environment, clinicians need clear thought processes for diagnosis and treatment. Ethical considerations, diagnosis, identity and previous history, contraindications, time of symptom onset (EDICT) can help decision-making in this situation.

  • thrombolysis
  • ischemic stroke
  • unknown
  • identification
  • aphasia

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  • Contributors SMB and MSR devised the article. All authors equally contributed to the creation and writing of the article.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by William Whiteley, Edinburgh, UK.

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