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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:

Diseases	History	Symptoms				Physical Examination					Diagnostic tests			Other Findings
		Headache	↓ LOC	Motor weakness	Abnormal sensory	Motor Deficit	Sensory deficit	Speech difficulty	Gait abnormality	Cranial nerves	CT/MRI	CSF	Gold standard test
Brain tumor	Weight loss Fatigue	+	–	–	–	+	+	+	–	+	+	Cancer cells	MRI	Cachexia Gradual progression of symptoms
Hemorrhagic stroke	Hypertension	+	+	+	+	+	+	+	+	–	+	NA	CT scan without contrast	Neck stiffness
Subdural hemorrhage	Trauma Fall	+	+	+	+	+	–	–	–	+	+	Xanthochromia	CT scan without contrast	Confusion Dizziness Nausea and vomiting
Neurosyphilis	Sexually transmitted disease	+	–	+	+	+	+	–	+	–	+	↑ Leukocytes and protein	Specific: CSF VDRL Sensitive: CSF FTA-Ab	Blindness Confusion Depression Abnormal gait
Complex or atypical migraine	Family history of migraine	+	–	+	+	–	–	+	–	–	–	NA	Clinical assesment	Presence of aura Nausea and vomiting
Hypertensive encephalopathy	Hypertension	+	+	–	–	–	–	+	+	–	+	NA	Clinical assesment	Delirium Cortical blindness Cerebral edema Seizure
Wernicke’s encephalopathy	History of alcohal abuse	–	+	–	–	–	+	+	+	+	–	NA	Clinical assesment and lab findings	Ophthalmoplegia Confusion
CNS abscess	History of drug abuse, endocarditis, immunosupression	+	+	–	–	+	+	+	–	–	+	↑ leukocytes, ↓ glucose and ↑ protien	MRI is more sensitive and specific	High grade fever fatigue Nausea and vomiting
Drug toxicity	Medication history of Lithium Sedatives Phenytoin Carbamazepine	–	+	–	+	+	+	–	+	–	–	NA	Drug screen test	–
Conversion disorder	History of emotional stress	+	+	+	+	+	+	+	+	–	–	NA	Diagnosis of exclusion	Tremor Blindness Difficulty swallowing
Metabolic disturbances (electrolyte imbalance, hypoglycemia)	–	–	+	+	+	+	+	–	–	+	–	Hypoglycemia, hyponatremia, hypernatremia, hypokalemia, and hyperkalemia	Depends on the cause	Confusion Seizure Palpitation Sweating Dizziness Hypoglycemia
Meningitis or encephalitis	History of fever and malaise	+	–	–	–	–	+	+	–	–	–	↑ Leukocytes, ↑ protein, ↓ glucose	CSF analysis	Fever Neck rigidity
Multiple sclerosis exacerbation	History of relapses and remissions	–	–	+	+	–	+	+	+	+	+	↑ CSF IgG levels, (monoclonal bands)	Clinical assesment and MRI	Blurry vision Urinary incontinence Fatigue
Seizure	Previous history of seizures	+	+	–	–	+	+	–	–	+	–	Mass lesion	Clinical assesment and EEG	Confusion Apathy Irritability

Common Causes of Sick sinus syndrome
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Images

Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia

Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia

Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia

Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia

Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia

Contrast enhanced CT: Aortic intramural hematoma, Courtesy of radiopaedia

Disease Name	Age of Onset	Gender Preponderance	Signs/Symptoms	Imaging Feature(s)	Macroscopic Feature(s)	Microscopic Feature(s)	Laboratory Findings(s)	Other Feature(s)	ECG view