Head Position in Acute Stroke: Does It Matter?

A randomized trial shows no difference in outcomes after lying flat or having the head raised for 24 hours after a stroke.

For patients with an acute stroke, lying flat with the head facing up may improve blood flow to the brain, thereby reducing the neurologic deficits of some patients. However, lying flat can also increase the risk for aspiration pneumonia. In contrast, sitting up at 30 degrees has been postulated to decrease the risk for raised intracranial pressure. Guidelines remain uncertain regarding head position in acute stroke.

These investigators randomly assigned 11,093 patients (mean age, 68; 40% women, recruited from 9 countries) to either lying flat or sitting up. Patients in the lying-flat group were asked to maintain the position for 24 hours, even for eating and toileting. If necessary, the assigned position could be interrupted for three nonco…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Head Position in Acute Stroke: Does It Matter?

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Reviewing Author