We have a 17-bed Acute Stroke Unit (ASU) as part of Healthcare for London’s redesign of the specialist stroke services across London. The Acute Stroke Unit (ASU) is the next step of care for stroke patients who come to the Emergency Stroke Unit (ESU) and Hyper-acute Stroke Unit (HASU) at UCLH. This unit aims to maximise functional recovery by exploring all means of neural protection and restoration after single incident brain injury. This provides organised acute inpatient treatment, care and rehabilitation followed by structured referral and follow-up for patients who have suffered stroke or a brain injury due to stroke, subarachnoid haemorrhage or head injury.
Inpatient activity is complemented by a nurse specialist-led outreach service to each of the hospitals in the Trust and a follow-up outpatient service for recently discharged inpatients. This service includes a one-stop stroke and TIA clinic and a two-stop brain injury clinic, when outpatients have imaging and a neuropsychological assessment on the same day (stroke) or two weeks previously (brain injury), followed by consultant-led clinical assessment. The service has close clinical links with the Hyperacute Stroke Unit at UCH, as well as the Neurorehabilitation Unit and Department of Neuropsychology at NHNN, and the Cardiac Department at the Heart Hospital.
We care for patients with:
- Arteriovenous malformations (AVMs)
- Carotid stenosis
- Head injury
- Intracerebral haemorrhage
- Moyamoya disease
- Subarachnoid haemorrhage
- Transient ischsaemic attack (TIA)
Approximately 300 inpatients are seen each year - all are emergency admissions. Approximately 600 outpatients are seen, with waiting times varying according to clinical need from zero to four weeks.
We run dedicated follow up clinics for brain injured patients, either following discharge from hospital or the emergency department. The patients are initially seen by a consultant and often have complex neurobehavioural and neurophysical needs requiring ongoing care and support. We also initiate referrals to other neuro-specialist services and have a dedicated neuropsychologist working within our team.
All patients have access to a clinical nurse specialist with a dedicated clinic. Our neuropsychologist can offer outpatient cognitive and behavioural feedback and rehabilitation, and support for emotional difﬁculties that occur after brain injury.
Patients will continue to be supported in the nurse-led follow up clinic until they can be discharged into the sole care of their GP.