ischaemic stroke head position

Researchers investigate how two different head positions influence recovery from ischaemic stroke. They found no differences between the sitting and laying positions.


When a person experiences ischaemic stroke, the following treatment is essential to a full recovery. In the past, several small studies have seen that lying down flat in supine position helps increase blood flow to major arteries and improves oxygenation of the brain. This is in contrast to the sitting-up position, which appears to relieve blood pressure in the skull. Knowing which position is optimal for ischemic stroke recovery could help develop a better protocol for stroke care. The authors of a recent study published in the New England Journal of Medicine compared the two head positions to determine which is more beneficial to stroke recovery.

Patients older than 18 years of age with a clinical diagnosis of acute stroke were eligible for the study. Across nine different countries, a total of 11,093 patients were randomly assigned to recover in the lying down or sitting-up position. A sitting-up position was defined as the patient’s head elevated at least 30 degrees from body level. The designated position was maintained for 24 hours following hospital admission. After 90 days, the patients were given assessments of the level of disability they had due to their stroke. This was done through a Rankin scale, which assigned a score of 0 to 6, higher scores indicating a greater degree of disability.

In the end, there were no differences between lying down or sitting-up following a stroke. Most likely, any differences in blood flow to the brain caused by lying down or sitting-up were negligible because the treatment lasted for such a short time. Additionally, since these recovery positions were assigned after the crucial treatment window immediately following ischemic stroke, perhaps administering these positions earlier on could help recovery odds.

Written by Harin Lee, BSc

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