TY - JOUR T1 - Treating by numbers JF - Practical Neurology JO - Pract Neurol DO - 10.1136/practneurol-2018-001939 SP - practneurol-2018-001939 AU - Timothy J Counihan Y1 - 2018/06/01 UR - http://pn.bmj.com/content/early/2018/06/01/practneurol-2018-001939.abstract N2 - Registrar: ‘Hello, am I speaking with the consultant neurologist on-call?’Consultant: ‘Regrettably! Yes that’s me. What is it?’R: ‘Hi this is Dr Richter, medical reg. on call. Sorry to disturb you so late, but we’ve got a FAST1 positive in A&E.’C: ‘A what?’R: ‘A FAST-positive patient.’C: ‘I assume that’s worse than a FAST-negative patient then. Go on.’R: ‘Well the NIHSS2 is 24 but her GCS3 4 is 12 currently. Before we got the CT, I was worried about a subarachnoid, because her Hunt & Hess5 was 4.’C: ‘Gosh.’R: ‘But thankfully the CT showed no bleed, but the ASPECTS6 was 6.’C: ‘Six, did you say? That doesn’t sound too bad. At least it’s not 10 or something.’R: ‘Actually 10 is a normal score. You really don’t want an ASPECTS lower than 6.’C: ‘I see. So what are you recommending to do?’R: ‘Well, time is brain, Professor, and I think it would be good to keep our door-to-needle stats … ER -