Stroke unit care Management in a geographically defined stroke unit that is staffed by medical,

nursing and allied health clinicians who have an interest in stroke is likely the intervention with the
greatest overall benefit as care is guided by standardized protocols that reduce both morbidity and
mortality for all forms and severity of stroke. The precise components that contribute to this benefit
are not known, but prevention of complications (such as aspiration pneumonia, venous
thromboembolism and pressure ulcers), early institution of targeted secondary prevention and
rehabilitation are likely to be key. Stroke unit care is possible in resource-constrained environments
and is a key component of the World Stroke Organization’s global guidelines106

. Stroke unit care is the prerequisite foundation on which more complex acute interventions are
built5 . One key aspect of stroke unit care is the targeting of secondary prevention strategies based
on an understanding of stroke mechanism (Table 1). Indeed, although some aspects of care are
generic, such as lowering blood pressure, some interventions are specific and require identification
of the cause of stroke, such as anticoagulation for atrial fibrillation, carotid endarterectomy for
severe symptomatic atherosclerotic stenosis and percutaneous closure of PFO. By contrast, the
initial choice of reperfusion therapy is determined by the location of vessel occlusion and the
presence of viable brain tissue, and is generally not influenced by the mechanism of stroke.