Please select the eligibility criteria that correspond to the clinical trial below.
Title: An Investigator Initiated, International Collaborative, Multicentre, Cluster Crossover, Randomised Controlled Trial to Establish the Effects of Head Positioning on Death or Disability in Patients With Acute Stroke
Brief Summary: This study is an investigator-initiated and conducted, international collaborative, regionally organised, multicentre, prospective, cluster randomised, crossover, blinded outcome assessment study to compare the effectiveness of the lying flat (0°) head position with the sitting up (=30°) head position, in the first 24 hours of admission to hospital for patients with acute stroke, on the poor outcome of death or disability over the subsequent 90 days.


Options:
A: Inclusion Criteria:

* Adults over 18 years ( the age for adults may vary in different countries)
* Have a clinical diagnosis of acute stroke (i.e. with a persistent neurological deficit on presentation)
* Presentation to hospital including in-hospital event and hospital transfers , with a stroke

Exclusion Criteria:

* Transient ischaemic attack (TIA) (i.e. symptoms fully resolved upon presentation).
* Definite clinical contraindication or indication to either sitting up head position or lying flat head position.
* Significant medical condition that takes priority in care and where adherence to the randomised head position is not possible on another ward/department of the hospital.
* Immediate transfer from the Emergency Department (ED) or admission, to another ward for medical treatment (e.g. for haemodialysis) or surgery (e.g. carotid endarterectomy, haematoma evacuation) where adherence to the randomised head position is not possible
B: Inclusion Criteria:

* Age 18 years or older
* Persistent neurological impairment at the participated time, related to an ischemic stroke defined by a sudden neurological deficit. The neurological deficit must not accompany hemorrhage on cerebral tomodensitometry which occurs on the same day or the day previous to the participation
* Patient hospitalized in Neurology department on the day of the participation
* Patient affiliated to the social security

Exclusion Criteria:

* Malignant cerebral infarction, loss of consciousness, comatose with GCS under 13, cerebral herniation, life- threatening infarction.
* Minor neurological deficit defined by isolated facial palsy, dysarthria, hemianopia, sensitive impairment, or every clinical condition that let the physician thinks that the stay in the hospital would be less than 72 hours.
* Known intracranial stenosis above 50% linked to the current infarction
* History of orthostatic neurological degradation
* Vomiting
* Deep venous thrombosis or suspicion of.
* Patients displaying a loss of autonomy with a Rankin score \>3 previous to stroke onset.
* Patient's refusal
* Patient under legal protection
C: Inclusion Criteria:

* Patients informed and giving their written consent.First
* Ever ischemic hemispheric or haemorrhagic stroke, unilateral, occurred between the 25th and the 72nd previous hours
* Age ≥ 18 years old
* Motricity quoted by an NIHSS \>=2 in the upper limb or in the lower limb

Exclusion Criteria:

* Patient without health insurance.
* Coma (NIHSS consciousness \> or = 2)
* Total recovery within the 24 first hours
* Brain stem or cerebellar stroke
* Previous neurological history, specially stroke or dementia
* Inability to understand the study
* Surgical treatment of the stroke
* Autonomy before stroke assessed by Rankin score different from 0
* Scheduled surgery in the following 15 days
D: Inclusion Criteria:

* Informed consent
* Clinical diagnosis of first or recurrent stroke, hemorrhage or infarct.
* Recruited within 24 hours of onset of stroke symptoms
* Admission in a stroke care unit
* Consciousness: At a minimum patient must at least react to verbal commands.

Exclusion Criteria:

* pre stroke mRS of 3,4 or 5
* Deterioration in patients condition resulting in direct admission to ICU, decision to palliate or surgery.
* Concurrent diagnosis of rapidly deteriorating disease
* Unstable coronary or other medical condition that is judged by the investigator to impose a hazard to the patient by involvement
* Patients unable to be mobilized within 24 hours of onset. (eg bed rest policy post tPA, lower limb fracture)
* Other interventional trials
* Systolic BP less than 110 or greater than 220mmHg
* Oxygen saturation of less than 92 % with supplementation
* Resting heart rate of less than 40 or greater than 110 beats per minute
* Temperature of greater than 38.5 degrees C

Answer: A