Appendix e-1

Description of case-based scenarios

Case 1A

65 year oldmale cabinetmaker, who lives alone and presented to the ED with left sided weakness. He has a past history of diabetes and hypertension. NIHSS on admission = 5 (Dysarthria=1, Facial palsy =1, motor arm =2, motor leg =1). His glucose on admission was 14.5 mmol/L. Stroke subtype was lacunar.

Case 1B

73 year old retired figure skater,with a history of hypertension, who was living independently. She presented to the ED with left sided weakness. NIHSS on admission = 3 (Dysarthria=1, motor arm =2). The stroke subtype was presumed to be small vessel disease (lacunar).

Case 2A

68 year old retired clinician. He has a history of hypertension and presented with L-sided weakness. He was previously independent. NIHSS on admission = 5 (Facial palsy =1, motor arm =2, motor leg =1, visual extinction=1). The stroke subtype was presumed to be non-lacunar.

Case 2B

59 year old male, otherwise healthy. He is a physical education professor who, 2 days after a neck trauma, presents with difficulty speaking and a mild right sided weakness. NIHSS on admission= 4 (Best language =2, facial palsy =1, motor arm =1). Stroke subtype was non-lacunar.

Case 3A

75 year old retired handyman, who lives alone. He presented with right sided weakness and mild aphasia. NIHSS on admission = 7 (Best language =2, facial palsy =1, motor arm =2, motor leg=2). He has a history of hypertension and was diagnosed with atrial fibrillation on arrival at hospital. Stroke subtype was presumed to be cardioembolic.

Case 3B

80 year old retired hairdresser, with a 10 year history of hypertension living with her son, who acts as her caregiver. She presented with sudden onset of left sided weakness and neglect. NIHSS on admission = 7 (Facial palsy =1, motor arm =2, motor leg =2, visual + sensory extinction=2). Stroke subtype was undetermined.

Case 4A

78 year old female, living alone, with a history of hypertension and a recent diagnosis of atrial fibrillation. She presented to the ED with right sided weakness and aphasia. NIHSS on admission =10 (Facial palsy =2, motor arm =3, motor leg =3, aphasia=2). Stroke type was non-lacunar.

Case 4B

78 year old piano teacher, who lives alone in her condo. She presented to hospital with right hemiplegia, and decreased level of consciousness. NIHSS on admission = 17 (LOC=1, Best gaze=2,Visual=2, Dysarthria=2, Facial palsy =2, motor arm =3, motor leg =3, Language 2). She has a history of hypertension. Stroke subtype was non-lacunar.

Case 5A

70 year old retired accountant from home, presented with L-sided weakness. He was previously independent and has had a history of hypertension for 10 years. NIHSS on admission =17 (LOC=1,Best gaze=2,Visual =2, Dysarthria=2,Face=2, motor arm =4, motor leg=4). The stroke subtype was presumed to be non-lacunar.

Case 5B

82 year old female, who lives independently, with a history of hypertension and atrial fibrillation. She presented with R-sided weakness and aphasia. NIHSS on admission =19 (LOC=1, LOC questions: 2, LOC commands: 2; Visual =2, Face=2, motor arm =3, motor leg=3, dysarthria=2, aphasia=2). Presented with cardioembolic stroke subtype.