What is the recommended head elevation for stroke patients?

• A. 30-45 degrees unless spinal trauma is suspected.
• B. 0-5 degrees.
• C. 60-75 degrees.
• D. 90 degrees.

Answer: (A)

Positioning matters because how you raise the head affects blood flow to the brain and the risk of aspiration. Elevating the head to about thirty to forty-five degrees helps drain venous blood from the brain, which lowers intracranial pressure, while still preserving enough pressure to maintain adequate cerebral perfusion. This range also aids airway protection and breathing without overly compromising blood pressure or cerebral blood flow.

Going too flat (0–5 degrees) doesn’t promote drainage and can keep intracranial pressure higher; lifting the head too high (60–75 degrees or 90 degrees) can reduce venous return and lower blood pressure, potentially decreasing cerebral perfusion. The caveat about spinal trauma means you should avoid neck movement or positioning that could worsen a spinal injury, so elevation is not used if spinal injury is suspected.

So, thirty to forty-five degrees is the best balance for stroke patients.