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Background In-hospital strokes account for 6.5%~15% of total strokes.Half of them are peri-operative strokes.Thrombolysis and new antiplatelet drugs have significantly improved prognosis of ischemic strokes, but only 2%~15% patients could accept thrombolysis on time due to its short time window(6~12h).Diagnosis of in-hospital stroke, especially peri-operative stroke is complex.