Whether positioning of acute stroke patients is important in outcome at 3 months is a matter of controversy. But the recent head post study showed no difference in outcome for small strokes, but may not be the same for large-artery strokes. Heamodynamics of the 3-pound jelly structure pooled in blood i.e Brain is a topic of debate in view of the positioning of brain at first floor of body where heart is at ground level. The autonomic compensatory mechanism which keeps this hemodynamic balance of distribution of 20% of blood volume to the brain in normal persons will be impaired in patients with stroke.
Hence for large strokes it will be ideal to keep patient in lying down position to maintain the blood flow through collaterals to save the brain. But the chances of aspiration pneumonia and reflux will be more in this position . Keeping this in mind motility agents like metocloperamide…
