Ischemic Stroke

Excerpt

Acute stroke is characterized by the sudden onset of focal neurological deficits within a vascular territory affecting the brain, retina, or spinal cord, caused by underlying cerebrovascular diseases. Stroke is prevalent across patient populations and is a leading cause of morbidity and mortality. Strokes are classified as ischemic or hemorrhagic, with hemorrhagic strokes further divided into intracerebral and subarachnoid hemorrhages. Among ischemic strokes, the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification system is commonly used to categorize subtypes, which include:

1. Cardioembolism

2. Small vessel occlusion

3. Large artery atherosclerosis

4. Stroke of undetermined etiology

5. Stroke of other determined etiology (possible or probable, depending on the results of ancillary studies)

A diagnosis is considered "probable" when clinical findings, neuroimaging data, and diagnostic study results consistently support a specific subtype, and other potential causes have been ruled out. On the other hand, a diagnosis is labeled "possible" when clinical findings and neuroimaging data suggest a specific subtype, but further studies have not been conducted to confirm it. As many patients undergo limited testing, these categories enable physicians to assign the most accurate subtype diagnosis possible.