Diagnosis of complete ischemic stroke
What is considered a complete ischemic stroke workup?
Patients with anterior circulation strokes need urgent carotid imaging. Intracranial as well as extracranial imaging is performed in most cases.
MRI is useful for detecting strokes not apparent on head CT: small strokes in multiple vascular distributions point to a cardioembolic source. In patients with suspected cardioembolism, echocardiogram (ECG) is indicated.
All patients should have telemetry for atrial fibrillation identification—ECGs are inadequate for detection of this important risk factor. Implantable event monitors reveal subclinical atrial fibrillation in a substantial proportion of patients with cryptogenic stroke and are warranted in cases where clinical suspicion is high.
