The Neuralert Stroke Monitor Pilot Trial

Eligibility Criteria

• * Age ≥ 22 years
• * Admitted to or planned admission to the Hospital of the University of Pennsylvania and followed by the Cardiothoracic (CT) Surgery or Vascular Surgery services
• * Considered at high risk for stroke while in the hospital based on:
• 1. Interventions or procedures performed during the hospitalization including: Intracardiac surgical or endovascular procedures including valve replacement, ascending aorta or aortic arch surgical or endovascular repair, and open surgical or endovascular carotid revascularization
• 2. Other CT surgery or Vascular surgery procedures in patients with high risk characteristics including: Atrial fibrillation, prior stroke/TIA, hypercoagulable state (i.e., prior clotting events attributed to active malignancy or a diagnosed thrombophilia) requiring lifelong anticoagulation, severely reduced left ventricular cardiac ejection fraction (i.e., \<30%) or anterior left ventricular wall akinesis, or age ≥ 80.
• * Any medical or psychological conditions that, in the opinion of the investigator, would compromise the subject's safety or successful participation in the study.
• * Baseline asymmetric upper extremity weakness as assessed by the study team at time of enrollment, defined as an NIHSS upper extremity motor score \>0 in either arm.
• * A limb amputation above the wrist in the upper extremities
• * Unwilling to provide informed consent and no legally authorized representative willing to provide informed consent if the patient is unable