Ischemic stroke differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
Aysha Aslam (talk | contribs) |
Aysha Aslam (talk | contribs) |
||
| Line 8: | Line 8: | ||
{| | {| | ||
|-style="background: #4479BA; color: #FFFFFF; text-align: center;" | |-style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
! rowspan="2" |Diseases | ! rowspan="2" |<small>Diseases</small> | ||
! colspan="4" |Diagnostic tests | ! colspan="4" |<small>Diagnostic tests</small> | ||
! colspan="4" |Physical Examination | ! colspan="4" |<small>Physical Examination</small> | ||
! colspan="4" |Symptoms | ! colspan="4" |<small>Symptoms</ref> | ||
! colspan="1" |Past medical history | ! colspan="1" |<small>Past medical history</small> | ||
! rowspan="2" |Other Findings | ! rowspan="2" |<small>Other Findings</small> | ||
|-style="background: #4479BA; color: #FFFFFF; text-align: center;" | |-style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
!Na+, K+, Ca2+ | !<small>Na+, K+, Ca2+</small> | ||
!CT /MRI | !<small>CT /MRI</small> | ||
!CSF Findings | !<small>CSF Findings</small> | ||
!Gold standard test | !<small>Gold standard test</small> | ||
!Motor Deficit | !<small>Motor Deficit</small> | ||
!Sensory deficit | !<small>Sensory deficit</small> | ||
!Speech or gait | !<small>Speech or gait</small> | ||
!Cranial | !<small>Cranial nerves</small> | ||
nerves | !<small>Headache</small> | ||
!Headache | !<small>LOC</small> | ||
!LOC | !<small>Motor weakness</small> | ||
!Motor weakness | !<small>Abnormal sensations</small> | ||
!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> | |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> | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center"|✔ | ||
|style="background: #F5F5F5; padding: 5px | |style="background: #F5F5F5; padding: 5px text-align:center" |Cancer cells<ref name="pmid21371327">{{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> | ||
|style="background: #F5F5F5; padding: 5px;" |MRI | |style="background: #F5F5F5; padding: 5px;" |MRI | ||
| style="background: #F5F5F5; padding: 5px;" | ✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" | ✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px; text-align:center" | | ||
| style="background: #F5F5F5; padding: 5px;" | ✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" | ✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
| Line 48: | Line 47: | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemorrhagic stroke | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemorrhagic stroke | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |Xanthochromia<ref name="pmid1198628">{{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> | |style="background: #F5F5F5; padding: 5px;" |Xanthochromia<ref name="pmid1198628">{{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> | ||
|style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{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="pmid21807345">{{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> | |style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{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="pmid21807345">{{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> | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | ✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" | ✔ | ||
| style="background: #F5F5F5; padding: 5px;" | ✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" | ✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |[[Hypertension]] | |style="background: #F5F5F5; padding: 5px;" |[[Hypertension]] | ||
| Line 64: | Line 63: | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" | Subdural hemorrhage | |style="background: #DCDCDC; padding: 5px; text-align: center;" | Subdural hemorrhage | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{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="pmid21807345">{{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> | |style="background: #F5F5F5; padding: 5px;" |CT scan without contrast<ref name="pmid21694755">{{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="pmid21807345">{{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> | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | ✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" | ✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |Trauma/fall | |style="background: #F5F5F5; padding: 5px;" |Trauma/fall | ||
| Line 80: | Line 79: | ||
|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: #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;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |'''↑''' [[Leukocytes]] and [[protein]] | |style="background: #F5F5F5; padding: 5px;" |'''↑''' [[Leukocytes]] and [[protein]] | ||
|style="background: #F5F5F5; padding: 5px;" |CSF [[VDRL]]-specifc | |style="background: #F5F5F5; padding: 5px;" |CSF [[VDRL]]-specifc | ||
CSF FTA-Ab -sensitive<ref name="pmid22421697">{{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> | CSF FTA-Ab -sensitive<ref name="pmid22421697">{{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> | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|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; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |STIs | |style="background: #F5F5F5; padding: 5px;" |STIs | ||
|style="background: #F5F5F5; padding: 5px;" |Blindness, confusion, [[depression]], | |style="background: #F5F5F5; padding: 5px;" |Blindness, confusion, [[depression]], | ||
| Line 106: | Line 105: | ||
|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; text-align:center" |✔ | ||
|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; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |Family history of [[migraine]] | |style="background: #F5F5F5; padding: 5px;" |Family history of [[migraine]] | ||
|style="background: #F5F5F5; padding: 5px;" |Presence of aura, [[nausea]], [[vomiting]] | |style="background: #F5F5F5; padding: 5px;" |Presence of aura, [[nausea]], [[vomiting]] | ||
| Line 118: | Line 117: | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |Diagnosis of exclusion | |style="background: #F5F5F5; padding: 5px;" |Diagnosis of exclusion | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|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; text-align:center" | ✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" |[[Tremor|Tremors]], [[blindness]], difficulty [[swallowing]] | |style="background: #F5F5F5; padding: 5px;" |[[Tremor|Tremors]], [[blindness]], difficulty [[swallowing]] | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Electrolyte disturbance | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Electrolyte disturbance | ||
|style="background: #F5F5F5; padding: 5px;" |↓ or '''↑''' | |style="background: #F5F5F5; padding: 5px; text-align:center" |'''↓''' or '''↑''' | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
| Line 148: | Line 147: | ||
| 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;" |'''↑''' Leukocytes, | | style="background: #F5F5F5; padding: 5px; text-align:center" |'''↑''' Leukocytes, | ||
'''↑''' Protein | '''↑''' Protein | ||
| Line 157: | Line 156: | ||
| 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; text-align:center" | ✔ | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| Line 169: | Line 168: | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Multiple sclerosis exacerbation | | 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; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" |'''↑''' levels | | style="background: #F5F5F5; padding: 5px; text-align:center" |'''↑''' levels | ||
| style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[MRI]] <ref name="pmid8274111">{{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> | | style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[MRI]] <ref name="pmid8274111">{{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> | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| 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; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" |History of relapses and remissions | | style="background: #F5F5F5; padding: 5px;" |History of relapses and remissions | ||
| style="background: #F5F5F5; padding: 5px;" |Blurry vision, [[urinary incontinence]], [[fatigue]] | | style="background: #F5F5F5; padding: 5px;" |Blurry vision, [[urinary incontinence]], [[fatigue]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Seizure | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Seizure | ||
| style="background: #F5F5F5; padding: 5px;" |↓ or '''↑''' | | style="background: #F5F5F5; padding: 5px; text-align:center" |↓ or '''↑''' | ||
| 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;" |Clinical assesment and [[EEG]] <ref name="pmid11385043">{{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> | | style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[EEG]] <ref name="pmid11385043">{{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> | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| 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; text-align:center" | ✔ | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" |Previous history of seizures | | style="background: #F5F5F5; padding: 5px;" |Previous history of seizures | ||
| style="background: #F5F5F5; padding: 5px;" |Confusion, apathy, irritability, | | style="background: #F5F5F5; padding: 5px;" |Confusion, apathy, irritability, | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hypoglycemia or hyperglycemia | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Hypoglycemia or hyperglycemia | ||
| style="background: #F5F5F5; padding: 5px;" |↓ or '''↑''' | | style="background: #F5F5F5; padding: 5px; text-align:center" |↓ or '''↑''' | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| Line 209: | Line 208: | ||
| 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; text-align:center" | ✔ | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |✔ | | style="background: #F5F5F5; padding: 5px; text-align:center" |✔ | ||
| style="background: #F5F5F5; padding: 5px;" |History of [[Diabetes mellitus|diabetes]] | | style="background: #F5F5F5; padding: 5px;" |History of [[Diabetes mellitus|diabetes]] | ||
| style="background: #F5F5F5; padding: 5px;" |[[Palpitation|Palpitations]], sweating, [[dizziness]] | | style="background: #F5F5F5; padding: 5px;" |[[Palpitation|Palpitations]], sweating, [[dizziness]] | ||
Revision as of 16:53, 9 November 2016
|
Ischemic Stroke Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Ischemic stroke differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Ischemic stroke differential diagnosis |
|
Risk calculators and risk factors for Ischemic stroke differential diagnosis |
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
| Diseases | Diagnostic tests | Physical Examination | Symptoms</ref> | Past medical history | Other Findings | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Na+, K+, Ca2+ | CT /MRI | CSF Findings | Gold standard test | Motor Deficit | Sensory deficit | Speech or gait | Cranial nerves | Headache | LOC | Motor weakness | Abnormal sensations | |||
| Brain tumour[1] | ✔ | Cancer cells[2] | MRI | ✔ | ✔ | ✔ | ✔ | Cachexia | ||||||
| Hemorrhagic stroke | ✔ | Xanthochromia[3] | CT scan without contrast[4][5] | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | Hypertension | Neck stiffness | |||
| Subdural hemorrhage | ✔ | CT scan without contrast[4][5] | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | Trauma/fall | Confusion, dizziness, nausea, vomiting | ||||
| Neurosyphilis[6][7] | ✔ | ↑ Leukocytes and protein | CSF VDRL-specifc
CSF FTA-Ab -sensitive[8] |
✔ | ✔ | ✔ | ✔ | ✔ | STIs | Blindness, confusion, depression,
Abnormal gait | ||||
| Complex or atypical migraine | Clinical assesment | ✔ | ✔ | Family history of migraine | Presence of aura, nausea, vomiting | |||||||||
| Conversion disorder | Diagnosis of exclusion | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | Tremors, blindness, difficulty swallowing | ||||||
| Electrolyte disturbance | ↓ or ↑ | Depends on the cause | Confusion, seizures | |||||||||||
| Meningitis or encephalitis | ↑ Leukocytes,
↑ Protein ↓ Glucose |
CSF analysis[9] | ✔ | ✔ | Fever, neck
rigidity | |||||||||
| Multiple sclerosis exacerbation | ✔ | ↑ levels | Clinical assesment and MRI [10] | ✔ | ✔ | ✔ | ✔ | ✔ | History of relapses and remissions | Blurry vision, urinary incontinence, fatigue | ||||
| Seizure | ↓ or ↑ | Clinical assesment and EEG [11] | ✔ | ✔ | ✔ | ✔ | Previous history of seizures | Confusion, apathy, irritability, | ||||||
| Hypoglycemia or hyperglycemia | ↓ or ↑ | Serum blood glucose | ✔ | ✔ | ✔ | History of diabetes | Palpitations, sweating, dizziness | |||||||
References
- ↑ Morgenstern LB, Frankowski RF (1999). "Brain tumor masquerading as stroke". J Neurooncol. 44 (1): 47–52. PMID 10582668.
- ↑ Weston CL, Glantz MJ, Connor JR (2011). "Detection of cancer cells in the cerebrospinal fluid: current methods and future directions". Fluids Barriers CNS. 8 (1): 14. doi:10.1186/2045-8118-8-14. PMC 3059292. PMID 21371327.
- ↑ Lee MC, Heaney LM, Jacobson RL, Klassen AC (1975). "Cerebrospinal fluid in cerebral hemorrhage and infarction". Stroke. 6 (6): 638–41. PMID 1198628.
- ↑ 4.0 4.1 Birenbaum D, Bancroft LW, Felsberg GJ (2011). "Imaging in acute stroke". West J Emerg Med. 12 (1): 67–76. PMC 3088377. PMID 21694755.
- ↑ 5.0 5.1 DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF; et al. (2011). "ACR Appropriateness Criteria® on cerebrovascular disease". J Am Coll Radiol. 8 (8): 532–8. doi:10.1016/j.jacr.2011.05.010. PMID 21807345.
- ↑ 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.
- ↑ Ho EL, Marra CM (2012). "Treponemal tests for neurosyphilis--less accurate than what we thought?". Sex Transm Dis. 39 (4): 298–9. doi:10.1097/OLQ.0b013e31824ee574. PMC 3746559. PMID 22421697.
- ↑ Carbonnelle E (2009). "[Laboratory diagnosis of bacterial meningitis: usefulness of various tests for the determination of the etiological agent]". Med Mal Infect. 39 (7–8): 581–605. doi:10.1016/j.medmal.2009.02.017. PMID 19398286.
- ↑ Giang DW, Grow VM, Mooney C, Mushlin AI, Goodman AD, Mattson DH; et al. (1994). "Clinical diagnosis of multiple sclerosis. The impact of magnetic resonance imaging and ancillary testing. Rochester-Toronto Magnetic Resonance Study Group". Arch Neurol. 51 (1): 61–6. PMID 8274111.
- ↑ Manford M (2001). "Assessment and investigation of possible epileptic seizures". J Neurol Neurosurg Psychiatry. 70 Suppl 2: II3–8. PMC 1765557. PMID 11385043.