Ischemic stroke differential diagnosis: Difference between revisions
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|-style="background: #4479BA; color: #FFFFFF; text-align: center;" | |-style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
!CBC | !CBC | ||
! | !Na+, K+, Ca2+ | ||
!CT /MRI | !CT /MRI | ||
!CSF Findings | !CSF Findings | ||
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!Motor Deficit | !Motor Deficit | ||
!Sensory deficit | !Sensory deficit | ||
! | !Speech or gait? | ||
!Cranial | !Cranial | ||
nerves | nerves | ||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" | Brain tumour<ref name="pmid10582668">{{cite journal| author=Morgenstern LB, Frankowski RF| title=Brain tumor masquerading as stroke. | journal=J Neurooncol | year= 1999 | volume= 44 | issue= 1 | pages= 47-52 | pmid=10582668 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582668 }} </ref> | |style="background: #DCDCDC; padding: 5px; text-align: center;" | Brain tumour<ref name="pmid10582668">{{cite journal| author=Morgenstern LB, Frankowski RF| title=Brain tumor masquerading as stroke. | journal=J Neurooncol | year= 1999 | volume= 44 | issue= 1 | pages= 47-52 | pmid=10582668 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582668 }} </ref> | ||
|style="background: #F5F5F5; padding: 5px;" |N | |||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | |||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |MRI | ||
|style="background: #F5F5F5; padding: 5px;" | <nowiki>+</nowiki> | |style="background: #F5F5F5; padding: 5px;" | <nowiki>+</nowiki> | ||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemorrhagic stroke | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemorrhagic stroke | ||
|style="background: #F5F5F5; padding: 5px;" |N | |||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | |||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name=":0"><ref name="pmid21694755">{{cite journal| author=Birenbaum D, Bancroft LW, Felsberg GJ| title=Imaging in acute stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 1 | pages= 67-76 | pmid=21694755 | doi= | pmc=3088377 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694755 }}</ref></ref><ref name=":1"><ref name="pmid21807345">{{cite journal| author=DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF et al.| title=ACR Appropriateness Criteria® on cerebrovascular disease. | journal=J Am Coll Radiol | year= 2011 | volume= 8 | issue= 8 | pages= 532-8 | pmid=21807345 | doi=10.1016/j.jacr.2011.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21807345 }}</ref></ref> | ||
| | |||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" | Subdural hemorrhage | |style="background: #DCDCDC; padding: 5px; text-align: center;" | Subdural hemorrhage | ||
|style="background: #F5F5F5; padding: 5px;" |N | |||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | |||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name=":0" /><ref name=":1" /> | ||
|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | |style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Neurosyphilis<ref name="pmid22482824">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824 }} </ref><ref name="pmid24365430">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref> | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Neurosyphilis<ref name="pmid22482824">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824 }} </ref><ref name="pmid24365430">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |lymphocytosis | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | |style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |CSF VDRL-specifc | ||
CSF FTA-Ab -sensitive<ref name="pmid22421697">{{cite journal| author=Ho EL, Marra CM| title=Treponemal tests for neurosyphilis--less accurate than what we thought? | journal=Sex Transm Dis | year= 2012 | volume= 39 | issue= 4 | pages= 298-9 | pmid=22421697 | doi=10.1097/OLQ.0b013e31824ee574 | pmc=3746559 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22421697 }}</ref> | |||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Complex or atypical migraine | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Complex or atypical migraine | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |N | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |Clinical assesment | |||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |Family history of migraine | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Conversion disorder | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Conversion disorder | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |N | ||
|style="background: #F5F5F5; padding: 5px;" |↓ | |style="background: #F5F5F5; padding: 5px;" |↓ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |Diagnosis of exclusion?? | ||
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|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Electrolyte disturbance | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Electrolyte disturbance | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |N | ||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Meningitis or encephalitis | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Meningitis or encephalitis | ||
|style="background: #F5F5F5; padding: 5px;" |TLC | |||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |CSF analysis<ref><ref name="pmid19398286">{{cite journal| author=Carbonnelle E| title=[Laboratory diagnosis of bacterial meningitis: usefulness of various tests for the determination of the etiological agent]. | journal=Med Mal Infect | year= 2009 | volume= 39 | issue= 7-8 | pages= 581-605 | pmid=19398286 | doi=10.1016/j.medmal.2009.02.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19398286 }}</ref></ref> | ||
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|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki> | |||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |Clinical assesment and MRI <ref><ref name="pmid8274111">{{cite journal| author=Giang DW, Grow VM, Mooney C, Mushlin AI, Goodman AD, Mattson DH et al.| title=Clinical diagnosis of multiple sclerosis. The impact of magnetic resonance imaging and ancillary testing. Rochester-Toronto Magnetic Resonance Study Group. | journal=Arch Neurol | year= 1994 | volume= 51 | issue= 1 | pages= 61-6 | pmid=8274111 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8274111 }}</ref></ref> | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |History of relapses and remissions | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |Clinical assesment and EEG <ref name="pmid11385043">{{cite journal| author=Manford M| title=Assessment and investigation of possible epileptic seizures. | journal=J Neurol Neurosurg Psychiatry | year= 2001 | volume= 70 Suppl 2 | issue= | pages= II3-8 | pmid=11385043 | doi= | pmc=1765557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11385043 }}</ref> | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |History of similar episodes in the past | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |HbA1c | ||
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|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" |History of diabetes | ||
|style="background: #F5F5F5; padding: 5px;" |Palpitations, sweating | |style="background: #F5F5F5; padding: 5px;" |Palpitations, sweating | ||
|} | |} | ||
Revision as of 02:16, 9 November 2016
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Ischemic Stroke Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ischemic stroke differential diagnosis On the Web |
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American Roentgen Ray Society Images of Ischemic stroke differential diagnosis |
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Risk calculators and risk factors for Ischemic stroke differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
Differential Diagnosis
| Diseases | Diagnostic tests | Physical Examination | Symptoms | Past medical history | Other Findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CBC | Na+, K+, Ca2+ | CT /MRI | CSF Findings | Gold standard test | Motor Deficit | Sensory deficit | Speech or gait? | Cranial
nerves |
Headache | LOC | Motor weakness | Abnormal sensations | |||
| Brain tumour[1] | N | + | MRI | + | + | + | + | Cahexia | |||||||
| Hemorrhagic stroke | N | + | CT scan without contrast</ref></ref> | + | + | + | + | + | + | Hypertension+ | |||||
| Subdural hemorrhage | N | + | CT scan without contrast[2][3] | + | + | + | + | + | + | Trauma/fall | |||||
| Neurosyphilis[4][5] | lymphocytosis | + | CSF VDRL-specifc
CSF FTA-Ab -sensitive[6] |
+ | + | + | + | + | STIs | ||||||
| Complex or atypical migraine | N | Clinical assesment | + | + | Family history of migraine | ||||||||||
| Conversion disorder | N | ↓ | Diagnosis of exclusion?? | + | + | + | + | + | + | ||||||
| Electrolyte disturbance | N | ||||||||||||||
| Intracranial neoplasm | |||||||||||||||
| Meningitis or encephalitis | TLC | CSF analysis</ref> | + | + | Fever, Neck
rigidity | ||||||||||
| Multiple sclerosis exacerbation | + | Clinical assesment and MRI </ref> | + | + | + | + | History of relapses and remissions | ||||||||
| Seizure | Clinical assesment and EEG [7] | + | + | + | + | History of similar episodes in the past | |||||||||
| Hypoglycemia or hyperglycemia | HbA1c | + | + | + | History of diabetes | Palpitations, sweating | |||||||||
References
- ↑ Morgenstern LB, Frankowski RF (1999). "Brain tumor masquerading as stroke". J Neurooncol. 44 (1): 47–52. PMID 10582668.
- ↑
- ↑
- ↑ Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.
- ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.
- ↑ Ho EL, Marra CM (2012). "Treponemal tests for neurosyphilis--less accurate than what we thought?". Sex Transm Dis. 39 (4): 298–9. doi:10.1097/OLQ.0b013e31824ee574. PMC 3746559. PMID 22421697.
- ↑ Manford M (2001). "Assessment and investigation of possible epileptic seizures". J Neurol Neurosurg Psychiatry. 70 Suppl 2: II3–8. PMC 1765557. PMID 11385043.