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Stroke

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Neurology

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Abstract

Stroke is the most common primary neurologic problem that leads to inpatient hospitalization. Understanding vascular neuroanatomy is essential for localizing stroke to a specific site in the brain, but vascular syndromes can be recognized quickly at the bedside with knowledge of common patterns of anterior circulation strokes, posterior circulation strokes, lacunar syndromes, cerebral venous sinus thromboses, and intracerebral hemorrhages. Mimics of stroke include the acute confusional state, focal neuropathies, re-expression of old strokes, and psychogenic disorders. Neuroimaging studies are essential to confirm the presence of a stroke, define its etiology, and determine appropriate treatment. Noncontrast head CT is the most important study when intravenous thrombolysis is being considered, though it is insensitive to most acute infarctions. Diffusion-weighted MRI is the imaging procedure that is most sensitive to ischemic stroke. Vascular imaging studies of the cervical and cerebral vasculature help to define the cause of a stroke. Intravenous thrombolysis is a potentially life-saving treatment that must be performed as soon as possible using a specific protocol. Secondary stroke prevention includes management of blood pressure and hyperlipidemia and selection of appropriate antiplatelet agents or anticoagulants. Carotid endarterectomy and stenting are potential treatment options for patients with strokes derived from the carotid artery. Intracranial hemorrhage is a life-threatening emergency that may be impossible to treat effectively in many cases.

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  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Andrew Tarulli

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Tarulli, A. (2016). Stroke. In: Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-29632-6_21

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  • DOI: https://doi.org/10.1007/978-3-319-29632-6_21

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