Skip to main content

Urgent need for updated NICE guidelines for imaging for strokes

Every year in the UK more than 100,000 people are diagnosed as having a stroke, a medical emergency that occurs when the blood supply to the brain is interrupted or seriously reduced.

Stroke remains the most prevalent disabling illness today and is the fourth most common cause of death in the UK.

Stroke services in the UK

It's widely accepted that receiving specialist treatment in the first 72 hours of having a stroke is vital for patients to survive and survive well. The guidelines for the diagnosis and treatment of strokes are provided by the National Institute for Health and Care Excellence (NICE).

Imaging for suspected stroke

Carotid artery disease occurs when fatty deposits (plaques) clog the blood vessels that deliver blood to the brain and head (carotid arteries). New research has found that:

  • An MRI scan of carotid plaque haemorrhage was the best indicator of risk of future strokes.

  • The risk of stroke is up to 20 times higher in people with plaque haemorrhage than those without.

  • This information is extremely helpful in identifying those at highest risk and therefore most likely to benefit from treatment.

Experts call for urgent update to guidelines

Current recommendations released by NICE make no reference to this technique, instead focusing on using imaging to quantify the degree of stenosis (narrowing of the blood vessel) and to exclude alternative causes of symptoms.

Now, experts at University Hospital Nottingham and the University of Nottingham say that it's high time that these recommendations were updated, particularly since there are severe pressures on MRI facilities partly as a result of the backlog caused by the pandemic. Updated recommendations would assist in prioritising the need for scanning.


As experts in medical negligence claims, sadly we have seen a number of cases arising from failures in diagnosing and treating strokes, including our client Priscilla who suffered a stroke after she was sent home from hospital having suffered 10 days of headaches and paralysis. 

Experts strongly believe that updated recommendations are overdue and we join them in urging NICE to consider this.

Find out more about Irwin Mitchell’s expertise in supporting those who have suffered following failures in diagnosing or treating strokes at our dedicated medical negligence section.