Stroke (diagnosed)

Have you ever been told by a doctor that you had a stroke?

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Stroke (No. of strokes)

In total, how many strokes have you had?

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Stroke #1

In which year did the first stroke occur?

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Stroke #1: In-patient treatment

Were you treated inpatient in a hospital at that time?

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Stroke #2

In which year did the second stroke occur?

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Stroke #2: In-patient treatment

Were you treated inpatient in a hospital at that time?

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Stroke #3

In which year did the third stroke occur?

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Stroke #3: In-patient treatment

Were you treated inpatient in a hospital at that time?

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Stroke #4

In which year did the fourth stroke occur?

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Stroke #4: In-patient treatment

Were you treated inpatient in a hospital at that time?

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Stroke #5

In which year did the fifth stroke occur?

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Stroke #5: In-patient treatment

Were you treated inpatient in a hospital at that time?

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First stroke (month)

When did the first stroke occur? Month

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First stroke (year)

When did the first stroke occur? Year

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Loss/changes in speech: Lasted 24 hours or longer

Have you ever had any sudden loss or changes in speech lasting 24 hours or longer?

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Loss/changes in speech: Suddenly

Did the episode come on suddenly?

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Loss of vision/blurring: Lasted 24 hours or longer

Have you ever had any sudden loss of vision, or blurring, lasting 24 hours or longer?

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Loss of vision/blurring: Suddenly

Did the episode come on suddenly?

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Spell of double vision: Lasted 24 hours or longer

Have you ever had a sudden spell of double vision, which lasted 24 hours or longer?

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Spell of double vision: If closed one eye

If you closed one eye, did the double vision go away?

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Spell of double vision: Suddenly

Did the episode come on suddenly?

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Numbness/tingling/loss of feeling: Lasted 24 hours or longer

Have you ever had sudden numbness, tingling, or loss of feeling on one side of your body, including your face, arm, or leg which lasted 24 hours or longer?

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Numbness/tingling/loss of feeling: When kept arms/legs in a certain position

Did the feeling of numbness or tingling occur only when you kept your arms or legs in a certain position?

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Numbness/tingling/loss of feeling: Suddenly

Did the episode come on suddenly?

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Episode of paralysis/weakness on one side of the body: Lasted 24 hours or longer

Have you ever had any sudden episode of paralysis or weakness on one side of your body, including your face, arm, or leg which lasted at least 24 hours?

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Episode of paralysis/weakness on one side of the body: Suddenly

Did the episode come on suddenly?

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Spells of dizziness/loss of balance/sensation of spinning: Lasted 24 hours or longer

Have you had any sudden spells of dizziness, loss of balance, or sensation of spinning which lasted 24 hours or longer?

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Spells of dizziness/loss of balance/sensation of spinning: When changing position

Did the dizziness, loss of balance or spinning sensation occur only when changing the position of your head or body?

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Transient ischemic attack/stroke (diagnosed)

Have you ever been told that you had a transient ischemic attack (TIA) or a stroke?

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Transient ischemic attack/stroke (age at diagnosis)

When? (age at diagnosis)

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Transient ischemic attack/stroke elaborated (description/free text)

Transient ischemic attack/stroke elaborated (description/free text)

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Transient ischemic attack (diagnosed)

Have you ever been told that you had a transient ischemic attack (TIA)?

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Transient ischemic attack (age at diagnosis)

When? (age at diagnosis)

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Transient ischemic attack elaborated (description/free text)

Transient ischemic attack elaborated (description/free text)

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Stroke notes elaborated (TIA)

Stroke notes elaborated (TIA)

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Stroke notes elaborated (stroke)

Stroke notes elaborated (stroke)

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Stroke notes elaborated (symptoms1)

Stroke notes elaborated (symptoms 1)

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Stroke notes elaborated (symptoms2)

Stroke notes elaborated (symptoms 2)

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Stroke notes elaborated

Stroke notes elaborated

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Stroke version

Stroke version

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