Stroke in evolution

Following the onset of symptoms, some patients continue to deteriorate over several hours or days. This is variably referred to as progressing or evolving stroke.49,50 Such patients require prompt reassessment and investigation, as there is a wide range of potential causes of deterioration, some of which may be reversible (Box 3.2). If we suspect that the cause is progressive thromboembolism, we might use intravenous heparin despite the lack of evidence supporting its effectiveness (see below).

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