Ischemic stroke differential diagnosis: Difference between revisions
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|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 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> | ||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Conversion disorder | |style="background: #DCDCDC; padding: 5px; text-align: center;" |Conversion disorder | ||
|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;" |Diagnosis of exclusion | |style="background: #F5F5F5; padding: 5px;" |Diagnosis of exclusion | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px;" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" |✔ | |style="background: #F5F5F5; padding: 5px;" |✔ | ||
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|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;" | | |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;" |Depends on the cause | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |style="background: #F5F5F5; padding: 5px;" | | ||
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|style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Meningitis or encephalitis | ||
| style="background: #F5F5F5; padding: 5px;" | | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
| style="background: #F5F5F5; padding: 5px;" |'''↑''' Leukocytes, | |||
'''↑''' Protein | |||
↓ Glucose | |||
| style="background: #F5F5F5; padding: 5px;" |[[CSF analysis]]<ref><nowiki><ref name="pmid19398286">{{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></nowiki></ref> | |||
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|style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|style="background: #F5F5F5; padding: 5px;" | | |||
|style="background: #F5F5F5; padding: 5px;" |[[CSF analysis]]<ref><ref name="pmid19398286">{{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></ref> | |||
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|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;" | | ||
|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]], Neck | | style="background: #F5F5F5; padding: 5px;" |[[Fever]], Neck | ||
rigidity | rigidity | ||
|- | |- | ||
|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;" |✔ | ||
|style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |'''↑''' levels | ||
|style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[MRI]] <ref><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></ref> | | style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[MRI]] <ref><nowiki><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></nowiki></ref> | ||
|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;" | | | 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;" |History of relapses and remissions | | style="background: #F5F5F5; padding: 5px;" |History of relapses and remissions | ||
|style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
|style="background: #DCDCDC; padding: 5px; text-align: center;" |Seizure | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Seizure | ||
|style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |↓ 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;" |✔ | ||
|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;" |✔ | | 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;" |History of similar episodes in the past | | style="background: #F5F5F5; padding: 5px;" |History of similar episodes in the past | ||
|style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
|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;" | | | style="background: #F5F5F5; padding: 5px;" |↓ or '''↑''' | ||
| style="background: #F5F5F5; padding: 5px;" | | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
| style="background: #F5F5F5; padding: 5px;" |Serum blood [[Glucose-1-phosphate adenylyltransferase|glucose]] | |||
| style="background: #F5F5F5; padding: 5px;" | | [[HbA1c]] | ||
| 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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|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;" |✔ | | style="background: #F5F5F5; padding: 5px;" |✔ | ||
|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 | | style="background: #F5F5F5; padding: 5px;" |[[Palpitation|Palpitations]], sweating | ||
|} | |} | ||
Revision as of 16:09, 9 November 2016
Ischemic Stroke Microchapters |
Diagnosis |
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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 | 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</ref> | MRI | ✔ | ✔ | ✔ | ✔ | Cachexia | ||||||
Hemorrhagic stroke | ✔ | xanthochromia</ref> | CT scan without contrast</ref></ref> | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | Hypertension | ||||
Subdural hemorrhage | ✔ | CT scan without contrast[2] | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | Trauma/fall | |||||
Neurosyphilis[3][4] | ✔ | ↑ Leukocytes and protein | CSF VDRL-specifc
CSF FTA-Ab -sensitive[5] |
✔ | ✔ | ✔ | ✔ | ✔ | STIs | |||||
Complex or atypical migraine | Clinical assesment | ✔ | ✔ | Family history of migraine | ||||||||||
Conversion disorder | Diagnosis of exclusion | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | |||||||
Electrolyte disturbance | ↓ or ↑ | Depends on the cause | ||||||||||||
Meningitis or encephalitis | ↑ Leukocytes,
↑ Protein ↓ Glucose |
CSF analysis</nowiki></ref> | ✔ | ✔ | Fever, Neck
rigidity | |||||||||
Multiple sclerosis exacerbation | ✔ | ↑ levels | Clinical assesment and MRI </nowiki></ref> | ✔ | ✔ | ✔ | ✔ | History of relapses and remissions | ||||||
Seizure | ↓ or ↑ | Clinical assesment and EEG [6] | ✔ | ✔ | ✔ | ✔ | History of similar episodes in the past | |||||||
Hypoglycemia or hyperglycemia | ↓ or ↑ | Serum blood glucose | ✔ | ✔ | ✔ | History of diabetes | Palpitations, sweating |
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.
- ↑ 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.
- ↑ Manford M (2001). "Assessment and investigation of possible epileptic seizures". J Neurol Neurosurg Psychiatry. 70 Suppl 2: II3–8. PMC 1765557. PMID 11385043.