Adult Stroke: Which of the following is part of initial management?

• A. Elevate head of stretcher to 30°
• B. Elevate to 60°
• C. Elevate to 0°
• D. Elevate to 45°

Answer: (A)

In the initial management of a suspected stroke, positioning to optimize brain perfusion and control intracranial pressure is important. Elevating the head of the bed to about 30 degrees helps promote venous drainage from the brain and reduces intracranial pressure without severely compromising arterial blood flow. This angle strikes a balance between lowering ICP and maintaining adequate cerebral perfusion.

Lower elevations, like a flat position, can allow ICP to rise, while higher elevations (45° or 60°) can decrease cerebral perfusion pressure by reducing arterial inflow. So the 30-degree elevation is the most suitable choice in the early stage.