Key Points The magnetic resonance imaging (MRI) acute stroke protocol includes T2-weighted imaging, fluid attenuated inversion recovery, gradient recalled echo, MR angiography, diffusion-weighted imaging, and perfusion-weighted imaging and can be acquired in 15–20 minutes. Diffusion-weighted MRI is an excellent tool…
Key Points Noncontrast computed tomography (CT) is the standard diagnostic modality for acute stroke patients. It reliably differentiates hemorrhagic from ischemic stroke, enables rapid thrombolysis, and thereby improves stroke recovery. On noncontrast CT, different types of “early ischemic changes” can…
Key Points Extracranial ultrasound assessment of the cervical arteries provides real-time, bedside evaluation of blood flow and vessel walls. Ultrasound examination is a non-invasive imaging modality of atherosclerosis in the extracranial arteries. For better yield of microembolic signals, power motion…
Key Points A high suspicion rate is needed to identify cerebral venous thrombosis (CVT). CVT rarely presents as a stroke syndrome, i.e., as the sudden onset of focal symptoms and signs in a patient with classical vascular risk factors. Confirmation…
Key Points In a percentage of patients, a defined etiology of ischemic stroke is not identified. These patients are categorized as cryptogenic (unknown cause) ischemic stroke. The estimated percentage of ischemic strokes that are cryptogenic varies from 15% to 35%,…
Key Points Migraine and particularly migraine with aura are associated with increased risk of ischemic and hemorrhagic stroke and other vascular events. In few cases does migraine directly result in a stroke. Treatment of stroke in patients with migraine is…
Key Points Patients with hematologic disorders, such as hereditary thrombophilias, are at higher risk for venous thrombosis than ischemic stroke, but these disorders account for a small, but important, percentage of stroke patients. The hereditary causes of protein S, protein…
Key Points CADASIL is a familial small artery disease responsible for migraine with aura, stroke, disability, and cognitive decline. The disease occurs during midadulthood. CADASIL is caused by mutations of NOTCH3 gene. CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts…
Key Points Moyamoya disease is an unusual form of chronic cerebrovascular occlusive disease that is characterized by angiographic findings of bilateral stenosis or occlusion at the terminal portion of the internal carotid artery together with an abnormal vascular network at…
Key Points Stroke in recreational substance users can be an indirect complication—for example, endocarditis and cardioembolism in parenteral drug users. With some drugs (e.g., cocaine), stroke appears to be the result of a direct effect. For illicit drugs, epidemiologic studies…