The most important aim should be to prevent stroke. Controlled studies have demonstrated that some interventions, such as adequate treatment of high blood pressure, anticoagulation treatment, surgical treatment, acetylsalicylic acid treatment and intervention against smoking for appropriate patients under certain conditions can help prevent stroke. Clinics with stroke units should continue to provide care, but should be assessed. Stroke patients require immediate acute care including rapid and precise diagnosis, assessment of benefits from active rehabilitation, a documented plan of nursing, medical and rehabilitative care, participation of the family and the development of plans for continuous care if necessary. Many routines currently used to treat stroke patients should be discontinued including determining blood cholesterol values, coagulation variables, and extensive heart studies, unless otherwise indicated. The need for angiography prior to carotid artery surgery should be reassessed. Many drug therapies, such as steroid treatment and infusions for blood viscosity, have no effect on stroke and/or are contraindicated. A plan should be developed to address how diagnosis and surgery of stenosis in the carotid artery should be delivered in Sweden. Cardiovascular research and research in the neurosciences directed towards underlying causes of stroke should be promoted. Current and proposed research on care for stroke patients should be monitored internationally. It is important to initiate scientific studies which assess the effect of physical therapy, occupational therapy, speech therapy, nursing and organisation of care for stroke patients. Different organisational approaches for care of stroke patients should be assessed.
Other output or dissemination activity: SBU has made a follow-up study of the report in patients treated in 9 hospitals in the north of Sweden and one large university hospital in the south. The study shows that the treatment in the acute phase is well in line with the recommendations in the report.