Neurol. praxi. 2019;20(1):12-16 | DOI: 10.36290/neu.2019.083
Basic algorithm for the diagnostic evaluation of ischemic stroke
- Neurologická klinika 2. LF UK a FN Motol, Praha
The presented article summarizes the algorithm for the diagnostic evaluation of patients with ischemic stroke. The general principles of stroke etiology classification, i.e. causative and phenotypic, are discussed. The classification system deemed the most practical for daily clinical practice SSS-TOAST is described in detail. SSS-TOAST is an upgrade of the most widely used classification system TOAST. It divides the ischemic strokes into five etiology subgroups (cardioembolic, large artery atherosclerosis, small artery occlusion, other etiology and undetermined). Based on the weight of evidence, each subtype is subdivided into three subcategories as evident, probable, or possible. The algorithm defines three diagnostic panels – basic (for ischemic stroke patients), advanced (if the basic panel examinations are negative or in all young stroke patients), and detailed (highly selective examinations for the rare causes of ischemic stroke).
Keywords: ischemic stroke, classification, diagnostic algorithm, SSS-TOAST
Published: March 1, 2019 Show citation
References
- Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gorgon DL, Marsh EE 3rd. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment 1993; 24(1): 35-41.
Go to original source... - Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Wolf ME, Hennerici MG. The ASCOD phenotyping of ischemic stroke (Updated ASCOphenotyping). Cerebrovasc. Dis., 2013; 36: 1-5. Go to original source...
- Ay H, Benner T, Murat Arsava E, Furie KL, Singhal AB, Jensen MB, Avata C, Towfighi A, Smith EE, Chong JY, Koroshetz WJ, Sorensen AG. A Computerized algorithm for etiologic classification of ischemic stroke: The Causative Classification of Stroke System 2007; 38(11): 2979-2984. Go to original source...
- Ay H, Furie KL, Singhal A, Smith WS, Sorensen AG, Koroshetz WJ. An evidence-based causative classification system for acute ischemic stroke. Annals of Neurology 2005; 58(5): 688-697. Go to original source...
Go to PubMed... - Hart RG, Diener HC, Coutts SB, Easton JD, Granger CB, O?Donnell MJ, Sacco RL, Connolly SJ, Cryptogenic Stroke ESUS International Working Group. Embolic strokes of undetermined source: the case for a new clinical construct. The Lancet Neurology 2014; 13(4): 429-438. Go to original source... Go to PubMed...
- Kent DM, Ruthazer R, Weimar C, Mas JL, Serena J, Homma S, DiAngelantonio E, DiTullio MR, Lutz JS, Elkind MS, Groffith J, Jaigobin C, Mattle HP, Michel P, Mono ML, Nedeltchev K, Papetti F, Thaler DE. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 2013; 81: 619-625. Go to original source... Go to PubMed...
- Tomek A. Vaskulitidy centrálního nervového systému. Neurol. praxi 2015; 16(6): 334-339.