Complementary examinations other than neuroimaging and neurosonology in acute stroke

Abstract

The etiologic diagnosis of cerebrovascular diseases requires non-routine complementary examinations to be performed. Thus, in specific cases, after neuroimaging (computed tomography/magnetic resonance imaging cerebral scan sequences) and neurosonology (Doppler test of the supra-aortic trunks, transcranial echography and echocardiography), which academically allow us to classify the patients according to their etiologic stroke subtype, further examinations must be used to make a correct etiologic diagnostic. The present review aims to update knowledge about the usefulness of the different tests of blood and urine, plain chest radiography, X-ray of the spine, skull and abdomen, lumbar puncture, electroencephalography, evoked potentials, polysomnography, and pathologic examination after biopsy of the artery, skin, muscles, nerves, meninges, and brain, in the management of patients who have suffered an acute stroke.

Keywords: Acute stroke; Blood biochemistry; Cerebrovascular disorders; Complementary examinations; Diagnostic techniques; Polysomnography.

Figure 1

Cheyne-Stokes respiration in a patient with lacunar cerebral infarction[49]. BPM: Blood pressure.

Figure 2

Temporal artery biopsy (elastin stain) in a patient (A) with Horton arteritis showing the presence of multinucleated giant cells (courtesy of Dr. Isidro Ferrer) (B).

Figure 3

Ragged red fibers in muscle biopsy, stained with modified Gomori trichrome, characteristics of mitochondrial encephalomyopathy.