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BACKGROUND : Stroke is a treatable disease that presents with rapidly developing clinical symptoms. Treatment depends on early diagnosis and transportation as quickly as possible to a treating hospital. Delayed diagnosis or misdiagnosis of stroke is common. Criteria for clinical diagnosis of stroke are needed. MATERIAL AND METHODS : Based on a review of the literature found in Medline this article proposes tools and criteria for diagnosis of a probable stroke before and after hospitalization. RESULTS AND INTERPRETATION : The diagnosis depends on rapidly developing symptoms or new symptoms on awakening. Symptoms associated with a high probability of stroke are acute unilateral paresis, lateralisation of symptoms to one hemisphere, high neurological score on NIH and symptoms corresponding to a certain vascular territory. Simple screening tools increase the pre-hospital probability of stroke. In hospital a definite diagnosis is based upon CT or MRI findings. Diffusion-weighted MRI is highly sensitive in acute ischemic stroke. The diagnosis is considered definite when clinical symptoms correspond with MRI findings. There are still no biochemical markers available to diagnose acute stroke. Diagnostic instruments improve diagnostic accuracy of acute stroke.

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