Acute Ischemic Stroke Evaluation and Management

Immediate Action Required

Initial Clinical Assessment (First 5–10 minutes)

Neuroimaging Priorities (Within 30–60 minutes of Arrival)

Laboratory and Cardiac Evaluation (Immediate)

Treatment Decisions Based on Imaging

Transfer and Pitfalls

Ongoing Monitoring (First 24–48 hours)

Acute Unilateral Arm Numbness – Evidence‑Based Recommendations

Immediate Actions

• Activate stroke code immediately for any patient with acute unilateral arm numbness because sensory deficits are present in 88 %–100 % of stroke presentations, placing the patient in the highest‑risk category. 4, 5
• Apply the FAST assessment to screen for additional stroke signs (facial asymmetry, speech difficulty, visual changes, other focal deficits) in patients presenting with unilateral arm numbness. 4

Risk Stratification

• Motor weakness accompanying unilateral arm numbness identifies the patient as very high risk for acute ischemic stroke and warrants urgent stroke‑ready evaluation. 6
• Speech or language disturbance accompanying unilateral arm numbness also classifies the patient as very high risk for stroke, necessitating immediate work‑up. 6

Trauma‑Related Considerations

• In patients with a recent limb trauma and acute unilateral arm numbness, CT angiography of the affected extremity should be performed when any of the following are present: