2022 Update information April 2022: We have: reviewed the evidence on blood pressure control for people with acute intracerebral haemorrhage and updated recommendations 1.5.4, 1.5.5, 1.5.6 and 1.5.8. May 2019: We have reviewed the evidence on thrombectomy (clot retrieval procedures) in ischaemic stroke, controlling high blood pressure in people with acute haemorrhagic stroke, the role of hemicraniectomy, and early mobilisation and optimum positioning of people with acute stroke. In addition, we have addressed the use of aspirin when transient ischaemic attack (TIA) is first suspected, the role of conventional risk stratification in TIA and the best approach to intracerebral imaging after TIA. These recommendations are marked [2019]. We have also made some changes without an evidence review: Recommendation 1.1.7 has been made consistent with new recommendations in relation to rapid referral and review in the TIA clinic. The remaining part of the recommendation has been replaced by recommendations 1.1.4 to 1.1.6. Recommendation 1.2.3 has been made consistent with new recommendations in relation to rapid referral and review in the TIA clinic. Recommendation 1.2.4 has been made consistent with new recommendations in relation to rapid referral and review in the TIA clinic and to omit the European Carotid Surgery Trial (ECST) criteria because these are no longer used. Recommendation 1.3.2 has been amended because early coagulation therapy is not relevant in this context. Non-enhanced means 'plain'; it is the basic form of CT scan without any contrast (that is, not CT angiography/perfusion). At this very early stage in the diagnostic pathway, acute stroke is still 'suspected'; the CT may show up an alternative diagnosis or further clinical assessment may also reveal an alternative diagnosis (the CT is often performed directly off the ambulance when there is little more than 'FAST +ve' criteria). 