In this short video, Michael T. Mullen, MD, offers a simple algorithm for the events that should prompt referral to a stroke center and/or consideration for thrombectomy: the 6+6 rule (NIH Stroke Scale score of 6+ and symptom onset within 6 hours). Dr. Mullen also explains the special cases that might be considered for a stroke center referral or thrombectom, including patients with NIHSS scores under 6, but who have cortical symptoms or a waxing/waning course.