The patient presenting with acute hemiparesis.

Acute hemiparesis is a common cause of presentation to hospital. In the majority of cases the cause is acute stroke, which is ischaemic in 80% of cases. This article aims to provide the reader with a practical approach to the initial management of suspected stroke.The problem-based format highlights some of the specific questions raised in the 2009 curriculum for training in Acute Internal Medicine, with reference to recent guidance from the National Institute for Health and Clinical Excellence (NICE).