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(Replaced content with "Syncope is classified into three types: * Cardiac * Neurogenic * vasovagal")
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[[Syncope]] is classified into three types:
Stroke, must be differentiated from other diseases that may cause, altered mental status, motor and or somatosensory deficits. The table below, summarizes the differential diagnosis for stroke:
* [[Cardiac]]
{|
* [[Neurogenic]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
* [[Vasovagal syncope|vasovagal]]
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |History
! colspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Symptoms
! colspan="5" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical Examination
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diagnostic tests
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other Findings
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Headache
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |↓ LOC
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Motor weakness
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Abnormal sensory
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Motor Deficit
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensory deficit
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Speech difficulty
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gait abnormality
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Cranial nerves
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CT/MRI
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |CSF
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Gold standard test
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain tumor]]<ref name="pmid105826682">{{cite journal| author=Morgenstern LB, Frankowski RF| title=Brain tumor masquerading as stroke. | journal=J Neurooncol | year= 1999 | volume= 44 | issue= 1 | pages= 47-52 | pmid=10582668 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10582668  }}</ref><ref name="pmid213713272">{{cite journal| author=Weston CL, Glantz MJ, Connor JR| title=Detection of cancer cells in the cerebrospinal fluid: current methods and future directions. | journal=Fluids Barriers CNS | year= 2011 | volume= 8 | issue= 1 | pages= 14 | pmid=21371327 | doi=10.1186/2045-8118-8-14 | pmc=3059292 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21371327  }}</ref>
| align="left" style="background:#F5F5F5;" |
*[[Weight loss]]
*[[Fatigue]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |Cancer cells
| align="center" style="background:#F5F5F5;" |MRI
| align="left" style="background:#F5F5F5;" |
*[[Cachexia]]
*Gradual progression of symptoms
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemorrhagic stroke]]<ref name="pmid216947552">{{cite journal| author=Birenbaum D, Bancroft LW, Felsberg GJ| title=Imaging in acute stroke. | journal=West J Emerg Med | year= 2011 | volume= 12 | issue= 1 | pages= 67-76 | pmid=21694755 | doi= | pmc=3088377 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21694755  }}</ref><ref name="pmid218073452">{{cite journal| author=DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF et al.| title=ACR Appropriateness Criteria® on cerebrovascular disease. | journal=J Am Coll Radiol | year= 2011 | volume= 8 | issue= 8 | pages= 532-8 | pmid=21807345 | doi=10.1016/j.jacr.2011.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21807345  }}</ref>
| align="left" style="background:#F5F5F5;" |
*[[Hypertension]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |NA
| align="center" style="background:#F5F5F5;" |CT scan without contrast
| align="left" style="background:#F5F5F5;" |
*[[Neck stiffness]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Subdural hematoma|Subdural hemorrhage]]<ref name="pmid216947552" /><ref name="pmid218073452" /><ref name="pmid11986282">{{cite journal| author=Lee MC, Heaney LM, Jacobson RL, Klassen AC| title=Cerebrospinal fluid in cerebral hemorrhage and infarction. | journal=Stroke | year= 1975 | volume= 6 | issue= 6 | pages= 638-41 | pmid=1198628 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1198628  }}</ref>
| align="left" style="background:#F5F5F5;" |
*[[Trauma]]
*Fall
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |[[Xanthochromia]]
| align="center" style="background:#F5F5F5;" |CT scan without contrast
| align="left" style="background:#F5F5F5;" |
*[[Confusion]]
*[[Dizziness]]
*[[Nausea and vomiting]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neurosyphilis]]<ref name="pmid224828242">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824  }}</ref><ref name="pmid243654302">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref><ref name="pmid224216972">{{cite journal| author=Ho EL, Marra CM| title=Treponemal tests for neurosyphilis--less accurate than what we thought? | journal=Sex Transm Dis | year= 2012 | volume= 39 | issue= 4 | pages= 298-9 | pmid=22421697 | doi=10.1097/OLQ.0b013e31824ee574 | pmc=3746559 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22421697  }}</ref>
| align="left" style="background:#F5F5F5;" |
*[[Sexually transmitted disease]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |↑ [[Leukocytes]] and [[protein]]
| align="center" style="background:#F5F5F5;" |Specific: CSF [[VDRL]]
Sensitive: CSF FTA-Ab
| align="left" style="background:#F5F5F5;" |
*[[Blindness]]
*[[Confusion]]
*[[Depression]]
*Abnormal [[gait]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |Complex or atypical [[migraine]]
| align="left" style="background:#F5F5F5;" |
*Family history of [[migraine]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |NA
| align="center" style="background:#F5F5F5;" |Clinical assesment
| align="left" style="background:#F5F5F5;" |
*Presence of [[aura]]
*[[Nausea and vomiting]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hypertensive encephalopathy]]
| align="left" style="background:#F5F5F5;" |
*[[Hypertension]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |NA
| align="center" style="background:#F5F5F5;" |Clinical assesment
| align="left" style="background:#F5F5F5;" |
*[[Delirium]]
*Cortical [[blindness]]
*[[Cerebral edema]]
*[[Seizure]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Wernicke's encephalopathy|Wernicke’s encephalopathy]]
| align="left" style="background:#F5F5F5;" |
*History of alcohal abuse
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |NA
| align="center" style="background:#F5F5F5;" |Clinical assesment and lab findings
| align="left" style="background:#F5F5F5;" |
*[[Ophthalmoplegia]]
*[[Confusion]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Brain abscess|CNS abscess]]
| align="left" style="background:#F5F5F5;" |
*History of [[drug abuse]], [[endocarditis]], [[immunosupression]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |↑ leukocytes, ↓ glucose and ↑ protien
| align="center" style="background:#F5F5F5;" |MRI is more sensitive and specific
| align="left" style="background:#F5F5F5;" |
*High grade [[fever]]
*[[fatigue]]
*Nausea and vomiting
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Drug toxicity]]
| align="left" style="background:#F5F5F5;" |Medication history of
*[[Lithium]]
*[[Sedatives]]
*[[Phenytoin]]
*[[Carbamazepine]]
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |NA
| align="center" style="background:#F5F5F5;" |Drug screen test
| align="center" style="background:#F5F5F5;" |–
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Conversion disorder]]
| align="center" style="background:#F5F5F5;" |
*History of [[emotional stress]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |NA
| align="center" style="background:#F5F5F5;" |Diagnosis of exclusion
| align="left" style="background:#F5F5F5;" |
*[[Tremor]]
*[[Blindness]]
*Difficulty [[swallowing]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |Metabolic disturbances ([[electrolyte imbalance]], [[hypoglycemia]])
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |[[Hypoglycemia]], [[hyponatremia]], [[hypernatremia]], [[hypokalemia]], and [[hyperkalemia]]
| align="center" style="background:#F5F5F5;" |Depends on the cause
| align="left" style="background:#F5F5F5;" |
*[[Confusion]]
*[[Seizure]]
*[[Palpitation]]
*[[Sweating]]
*[[Dizziness]]
*[[Hypoglycemia]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Meningitis]] or [[encephalitis]]<ref name="pmid193982862">{{cite journal| author=Carbonnelle E| title=[Laboratory diagnosis of bacterial meningitis: usefulness of various tests for the determination of the etiological agent]. | journal=Med Mal Infect | year= 2009 | volume= 39 | issue= 7-8 | pages= 581-605 | pmid=19398286 | doi=10.1016/j.medmal.2009.02.017 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19398286  }}</ref>
| align="left" style="background:#F5F5F5;" |
*History of [[fever]] and [[malaise]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |↑ Leukocytes, ↑ protein, ↓ glucose
| align="center" style="background:#F5F5F5;" |[[CSF analysis]]
| align="left" style="background:#F5F5F5;" |
*[[Fever]]
*Neck rigidity
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]] exacerbation<ref name="pmid82741112">{{cite journal| author=Giang DW, Grow VM, Mooney C, Mushlin AI, Goodman AD, Mattson DH et al.| title=Clinical diagnosis of multiple sclerosis. The impact of magnetic resonance imaging and ancillary testing. Rochester-Toronto Magnetic Resonance Study Group. | journal=Arch Neurol | year= 1994 | volume= 51 | issue= 1 | pages= 61-6 | pmid=8274111 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8274111  }}</ref>
| align="left" style="background:#F5F5F5;" |
*History of relapses and remissions
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |↑ CSF IgG levels, (monoclonal bands)
| align="center" style="background:#F5F5F5;" |Clinical assesment and [[MRI]]
| align="left" style="background:#F5F5F5;" |
*Blurry [[vision]]
*[[Urinary incontinence]]
*[[Fatigue]]
|-
! style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Seizure]]<ref name="pmid113850432">{{cite journal| author=Manford M| title=Assessment and investigation of possible epileptic seizures. | journal=J Neurol Neurosurg Psychiatry | year= 2001 | volume= 70 Suppl 2 | issue=  | pages= II3-8 | pmid=11385043 | doi= | pmc=1765557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11385043  }}</ref>
| align="left" style="background:#F5F5F5;" |
*Previous history of [[seizures]]
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" | +
| align="center" style="background:#F5F5F5;" |–
| align="center" style="background:#F5F5F5;" |Mass lesion
| align="center" style="background:#F5F5F5;" |Clinical assesment and [[EEG]]
| align="left" style="background:#F5F5F5;" |
*[[Confusion]]
*[[Apathy]]
*[[Irritability]]
|}
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==Images==
[[Image:Intramural-hematoma-006.jpg|thumb|350px|left|Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia]]
<br clear="left" />
[[Image:Intramural-hematoma-005.jpg|thumb|350px|left|Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia]]
<br clear="left" />
[[Image:Intramural-hematoma-007.jpg|thumb|350px|left|Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia]]
<br clear="left" />
[[Image:Intramural-hematoma-002.jpg|thumb|350px|left|Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia]]
<br clear="left" />
[[Image:Intramural-hematoma-003.jpg|thumb|350px|left|Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia]]
<br clear="left" />
[[Image:Intramural-hematoma-004.jpg|thumb|350px|left|Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia]]
<br clear="left" />
 
 
 
 
{| border="3"
|+
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Disease Name}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Age of Onset}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Gender Preponderance}}
! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| Signs/Symptoms}}
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<references />

Latest revision as of 00:32, 12 August 2021

Syncope is classified into three types:

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