Ischemic stroke differential diagnosis: Difference between revisions

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Revision as of 21:39, 8 November 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S [2]

Overview

Differential Diagnosis

Neurosyphilis can present with strokes and must be differentiated from other causes.

Presents as weakness, sensory loss, gait abnormality and cranial nerve damage.

Diseases	Laboratory Findings				Physical Examination				History and Symptoms				Other Findings
Diseases	CBC	CT scan	BMP	CSF changes	Motor strength	Sensory deficit	Reflexes	Gait	Headache	LOC	Motor weakness	Abnormal sensations	Other Findings
Brain tumour^[1]					↓	+			+
Hemorrhagic stroke						+			+	+
Subdural hemorrhage									+
Neurosyphilis^[2]^[3]			+		↓
Complex or atypical migraine	↑								+
Conversion disorder		↓			↓					+
Electrolyte disturbance
Intracranial neoplasm
Meningitis or encephalitis					↓				+
Multiple sclerosis exacerbation					↓
Seizure					↓					+
Hypoglycemia or hyperglycemia										+

References

↑ Morgenstern LB, Frankowski RF (1999). "Brain tumor masquerading as stroke". J Neurooncol. 44 (1): 47–52. PMID 10582668.
↑ Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.
↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.

Template:WikiDoc Sources

[pmid10582668-1] Morgenstern LB, Frankowski RF (1999). "Brain tumor masquerading as stroke". J Neurooncol. 44 (1): 47–52. PMID 10582668.

[pmid22482824-2] Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.

[pmid24365430-3] Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.

[1]

[2]

[3]

@@ Line 5: / Line 5: @@
 ==Differential Diagnosis==
-[[Neurosyphilis]] can present with strokes and must be differentiated from other causes.<ref name="pmid24365430">{{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>
+[[Neurosyphilis]] can present with strokes and must be differentiated from other causes.
 *Presents as [[weakness]], [[sensory loss]], [[gait]] abnormality and [[cranial nerve]] damage.
 {|
@@ Line 15: / Line 15: @@
 ! rowspan="2" |Other Findings
 |-style="background: #4479BA; color: #FFFFFF; text-align: center;"
-!Lab Test 1
+!CBC
-!Lab Test 2
+!CT scan
-!Lab Test 3
+!BMP
-!Lab Test 4
+!CSF changes
-!Physical Finding 1
+!Motor strength
-!Physical Finding 2
+!Sensory deficit
-!Physical Finding 3
+!Reflexes
-!Physical Finding 4
+!Gait
-!Finding 1
+!Headache
-!Finding 2
+!LOC
-!Finding 3
+!Motor weakness
-!Finding 4
+!Abnormal sensations
 |-
 |style="background: #DCDCDC; padding: 5px; text-align: center;" | Brain tumour<ref name="pmid10582668">{{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>
@@ Line 33: / Line 33: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Decreased muscle strength
+|style="background: #F5F5F5; padding: 5px;" |↓
-|style="background: #F5F5F5; padding: 5px;" |Sensory loss
+|style="background: #F5F5F5; padding: 5px;" |      <nowiki>+</nowiki>
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |      <nowiki>+</nowiki>
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Headache
-|style="background: #F5F5F5; padding: 5px;" |Motor weakness
-|style="background: #F5F5F5; padding: 5px;" |Seizures
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
@@ Line 49: / Line 49: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |      <nowiki>+</nowiki>
+|style="background: #F5F5F5; padding: 5px;" | <nowiki>+</nowiki>
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Headache
-|style="background: #F5F5F5; padding: 5px;" |Motor weakness
-|style="background: #F5F5F5; padding: 5px;" |History of hypertension
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
@@ Line 67: / Line 67: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Severe headache
+|style="background: #F5F5F5; padding: 5px;" |     <nowiki>+</nowiki>
-|style="background: #F5F5F5; padding: 5px;" |Loss of consciousness
+|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Vomiting
+|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Muscle weakness
+|style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |-
-|style="background: #DCDCDC; padding: 5px; text-align: center;" |Neurosyphilis
+|style="background: #DCDCDC; padding: 5px; text-align: center;" |Neurosyphilis<ref name="pmid22482824">{{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="pmid24365430">{{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>
-|style="background: #F5F5F5; padding: 5px;" |CSF
+| style="background: #F5F5F5; padding: 5px;" |
-VDRL ++
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |↓
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
@@ Line 84: / Line 87: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Headache
-|style="background: #F5F5F5; padding: 5px;" |Muscle weakness
-|style="background: #F5F5F5; padding: 5px;" |Sensory disturbances
-|style="background: #F5F5F5; padding: 5px;" |cranial nerve involvement
-|style="background: #F5F5F5; padding: 5px;" |History of STIs
 |-
 |style="background: #DCDCDC; padding: 5px; text-align: center;" |Complex or atypical migraine
@@ Line 99: / Line 97: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Unilateral headache
+|style="background: #F5F5F5; padding: 5px;" |    <nowiki>+</nowiki>
-|style="background: #F5F5F5; padding: 5px;" |Aura causing visual and speech difficulties
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Family history of migraine
 |-
 |style="background: #DCDCDC; padding: 5px; text-align: center;" |Conversion disorder
@@ Line 109: / Line 107: @@
 |style="background: #F5F5F5; padding: 5px;" |↓
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |↓
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" | <nowiki>+</nowiki>
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Sudden loss of motor strength
-|style="background: #F5F5F5; padding: 5px;" |Loss of sensation or abnormal sensations
-|style="background: #F5F5F5; padding: 5px;" |Behavioural
-abnormalities
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
@@ Line 131: / Line 127: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Confusion
+|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Lack of orientation
+|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Seizures
+|style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
@@ Line 157: / Line 153: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |↓
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |   <nowiki>+</nowiki>
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Fever
-|style="background: #F5F5F5; padding: 5px;" |Neck stiffness
-|style="background: #F5F5F5; padding: 5px;" |loss of consciousness
-|style="background: #F5F5F5; padding: 5px;" |Cranial nerve damage
-|style="background: #F5F5F5; padding: 5px;" |Lack of
 |-
 |style="background: #DCDCDC; padding: 5px; text-align: center;" |Multiple sclerosis exacerbation
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |↓
 |style="background: #F5F5F5; padding: 5px;" |
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@@ Line 176: / Line 176: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Pre
-|style="background: #F5F5F5; padding: 5px;" |Visual changes
-|style="background: #F5F5F5; padding: 5px;" |Muscle weakness
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |Relapsing and remitting course
 |-
 |style="background: #DCDCDC; padding: 5px; text-align: center;" |Seizure
@@ Line 187: / Line 183: @@
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |↓
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |  <nowiki>+</nowiki>
-|style="background: #F5F5F5; padding: 5px;" |
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@@ Line 207: / Line 203: @@
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 |style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
+|style="background: #F5F5F5; padding: 5px;" |  <nowiki>+</nowiki>
 |style="background: #F5F5F5; padding: 5px;" |
 |style="background: #F5F5F5; padding: 5px;" |

Ischemic stroke differential diagnosis: Difference between revisions

Revision as of 21:39, 8 November 2016

Overview

Differential Diagnosis

References

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