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Overview of the evaluation of stroke

Louis R Caplan, MD
Section Editor
Scott E Kasner, MD
Deputy Editor
John F Dashe, MD, PhD


The symptoms of brain ischemia may be transient, lasting seconds to minutes, or may persist for longer periods of time. Symptoms and signs remain indefinitely if the brain becomes irreversibly damaged and infarction occurs. Unfortunately, neurologic symptoms do not accurately reflect the presence or absence of infarction, and the tempo of the symptoms does not indicate the cause of the ischemia [1,2]. This is a critical issue because treatment depends upon accurately identifying the cause of symptoms.

An overview of the evaluation of patients who present with neurologic symptoms that may be consistent with stroke is discussed here. This evaluation includes the following:

Understanding the classification of stroke

An initial quick evaluation to stabilize vital signs, determine if intracranial hemorrhage is present, and, in patients with ischemic stroke, decide if reperfusion therapy is warranted (see "Initial assessment and management of acute stroke")

Forming a hypothesis of the stroke etiology based upon the history, physical examination, and initial brain imaging study (usually a noncontrast head CT scan)

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Literature review current through: Nov 2017. | This topic last updated: Oct 13, 2017.
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