Differential diagnosis of stroke
Stroke is a clinical syndrome. It is characterized by rapidly developing clinical symptoms and/or signs of focal/global and loss of cerebral function. The symptoms lasting more than 24 hours and may lead to death. Stroke syndrome has no apparent cause other than vascular origin.
Transient ischaemic attack is another clinical syndrome almost similar like stroke syndromes. It is characterized by an acute loss of focal cerebral or monocular function. The symptoms are lasting less than 24 hours. It has been thought the symptoms occur due to the inadequate blood supply to cerebral or ocular as a result of arterial thrombosis or embolism.
Differential diagnosis of stroke syndromes:
| TIA/stroke | Hemorrhage |
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Other differential diagnosis of “stroke” – the following problems may present like stroke. It should always be considered in unconscious patients or patients presented with muscle weakness or other neurological deficits.
- Metabolic/toxic encephalopathy (hypoglycemia, non ketotic hyperglycemia, Wernicke-Korsakoff syndrome, drug intoxication)
- Epileptic seizures (postictal Todd’s paresis)
- Hemiplegic migraine
- Structural intracranial lesions (e.g.: subdural hematoma, brain tumor, arteriovenous malformation)
- Encephalitis (e.g.: herpes simplex virus), brain abscess, tuberculoma
- Head injury
- Hypertensive encephalopathy
- Relapsing multiple sclerosis
- Conversion disorders
- Hyperviscosity syndrome
- Peripheral nerve lesion (e.g.: Guillaine Barre syndrome)
Related:
Reference:
- Clinical Practice Guidelines. Management of Ischaemic Stroke. June 2006. Ministry of Health Malaysia.
- David S. Smith et al. Field Guide to Bedside diagnosis. 2nd edition. 2007. Lippincott Williams and Wilkins.
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