Synthetic cases. These are fictional teaching vignettes, model-generated for testing clinical-reasoning systems. No real patients are described on these pages.
What this is
A bank of constructed referrals, written the way a referral actually arrives: spoken, compressed, incomplete, at three in the morning.
They are fiction — model-generated vignettes built for testing clinical-reasoning systems — and they are realistic precisely because the situations they describe are the ones every stroke physician recognises. No patient is described here; no patient material was used.
Why they exist
Gray zones only show themselves in concrete cases. A guideline can tell you that the evidence for thrombectomy in baseline-dependent patients is thin; it takes a 91-year-old with a dense M1 occlusion and a family in the relatives' room to show you what "thin" costs. The four cases below were chosen because each one walks straight into a territory where the randomised envelopes end — the same territories our in-press review of EVT contraindications works through.
The four cases
- Case 02 — frailty and baseline dependency. 91 years old, mRS 4, right M1 occlusion. The family wants to understand what else can be done.
- Case 05 — low NIHSS, tandem occlusion. NIHSS 5, tandem ICA and M1, thrombolysis running. A mild deficit and an ominous vessel.
- Case 06 — basilar, fluctuating, on a DOAC. NIHSS 4 then 16, mid-basilar, therapeutic apixaban, intubated. The exam is gone and the clock is running.
- Case 07 — large core, late window. 80 years old, 90 mL core, 14 hours. The tissue and the clock disagree.
Pages are numbered by bank ID; future cases join mechanically.
The invitation
Send us the anonymised cases where the guidelines went quiet.
Break the demo — send a case
For stroke physicians and vascular neurologists only. This is not a route for personal medical questions; if you are a patient or a relative, do not use this address. The demo does not run anonymously, and it is not a clinical service. Every case is reviewed and approved by the administrator before it runs; responses may take several days. Never use this for a live clinical decision — for acute stroke, follow your local pathway.
Your case must contain no images and no patient-identifying data, and it must be retrospective — not an active patient awaiting a decision. A case may appear on this site anonymously, as a constructed teaching case; you are named only if you ask to be.