①The National Institutes of Health Stroke Scale (NIHSS) is currently the most commonly used scale in the world;

② Chinese stroke patients’ clinical neurological deficit degree score scale (1995);

③Scandinavian Stroke Scale (SSS).

1) CT scan: It can accurately identify most intracranial hemorrhages and help identify non-vascular diseases (such as brain tumors). It is the preferred imaging method for patients with suspected acute stroke.

2) Perfusion CT imaging: It can distinguish reversible and irreversible ischemia, so it can identify the ischemia penumbra; it has certain reference value for guiding the thrombolytic treatment of acute stroke.

3) Conventional MRI: Conventional MRI (T1-weighted, T2-weighted and proton phase) is significantly better than plain scanning CT in identifying acute small infarction foci and posterior circulation ischemic stroke, and can identify subclinical infarction foci.

4) Multimodal MRI: Diffusion-weighted imaging (DWI) can detect ischemic foci within minutes of symptoms, and can determine the size, site and time early, which is more sensitive to early detection of small infarction foci than conventional MRI; Gradient echo sequence (GRE)/SWI can detect asymptomatic microbleeding that CT cannot be displayed; Perfusion-weighted imaging (PWI) can show cerebral hemodynamics; CT perfusion, MR perfusion and diffusion imaging can provide more information for the selection of suitable reperfusion treatment (intravenous thrombolysis, intravascular thrombosis and other intravascular interventional treatments); diffusion-perfusion mismatch (PWI shows low perfusion zone without diffusion abnormalities of its corresponding size) suggests that there is a penumbra of ischemic zombies.

5) Vascular lesion examination: Intracranial and external vascular lesion examinations help to understand the pathogenesis and causes of stroke and guide the selection of treatment plans; however, such examinations should be avoided to delay the treatment of thrombolysis or endovascular thrombectomy. Commonly used examinations include carotid artery ultrasound, transcranial Doppler (TCD), MRA, high-resolution magnetic resonance imaging (HRMRI), CTA and DSA, etc.

Patients suspected of stroke should be examined: ① Blood sugar, liver and kidney function and electrolytes;

② Electrocardiogram and myocardial ischemia markers;

③ Whole blood count, including platelet count;

④ Prothrombin time (PT)/international standardized ratio (INR) and activated partial thromboplastin time (APTT);

⑤ Oxygen saturation.

① Toxicological screening;

② Blood alcohol level;

③Pregnancy test;

④Artificial blood gas analysis (if hypoxia is suspected);

⑤ Lumbar puncture (suspicious subarachnoid hemorrhage and CT is not shown or suspected that stroke is secondary to infectious diseases);

⑥Electroencephalography (suspected epileptic attack);

⑦ Chest X-ray examination.