Skip to main content

Part of the book series: Current Clinical Neurology ((CCNEU))

  • 250 Accesses

Abstract

Ischemic stroke occurs as a result of an extremely heterogeneous group of vascular pathological events (Table 1). Because treatment is often aimed at attenuating a specific vascular disorder, identifying the underlying cause is critical for optimal stroke prevention. As an example, secondary stroke prevention for a young patient with endocarditis will differ substantially from that for an elderly patient with atrial fibrillation, although both conditions cause cardioembolic stroke.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adams HP Jr, Bendixen BH, Kappelle LJ,et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 1993;24:35–41.

    Article  PubMed  Google Scholar 

  2. Foulkes MA, Wolf PA, Price TR, Mohr JP, Hier DB. T he Stroke Data Bank: design, methods, and baseline characteristics. Stroke 1988;19:547–554.

    Article  PubMed  CAS  Google Scholar 

  3. Bamford J, Sandercock P, Dennis M, et al. Classification and natural nistory of clinically identifiable subtypes of cerebral infarction. Lancet 1991;337:1521–1528.

    Article  PubMed  CAS  Google Scholar 

  4. Awada A, al Rajeh S. The Saudi Stroke Data Bank. Analysis or tne first iuuu cases. Acta Neurol Scand 1999;100:265–269.

    Article  PubMed  CAS  Google Scholar 

  5. Bogousslavsky J, Van Melle G, Regli F. The Lausanne Stroke Registry: analysis ot 1000 consecutive patients with first stroke. Stroke 1988;19:1083–1092.

    Article  PubMed  CAS  Google Scholar 

  6. Low molecular weight heparinoid, ORG 10172 (danaparoid), and outcome atter acute ischemic stroke: a randomized controlled trial. The Publications Committee for the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) Investigators. JAMA 1998;279:1265–1272.

    Article  Google Scholar 

  7. Rothrock JF, Lyden PD, Brody ML, et al. An analysis of ischemic stroke in an urban southern California population. The University of California, San Diego, Stroke Data Bank. Arch Intern Med 1993;153:619–624.

    Article  PubMed  CAS  Google Scholar 

  8. Petty GW, Brown RD Jr, Whisnant JP, et al. Ischemic stroke subtypes: a popuiation-based study of incidence and risk factors. Stroke 1999;30:2513–2516.

    Article  PubMed  CAS  Google Scholar 

  9. Gross CR, Shinar D, Mohr JP, et al. Interobserver agreement in tne diagnosis of stroke type. Arch Neurol 1986;43:893–898.

    Article  PubMed  CAS  Google Scholar 

  10. Gordon DL, Bendixen BH, Adams HP Jr, et al IinterpnySiciai agreemennti the diagnosis of subtypes of acute ischemic stroke: implications for clinical trials. The TOAST Investigators. Neurology 1993;43:1021–1027.

    Article  PubMed  CAS  Google Scholar 

  11. Goldstein LB, Jones MR, Matchar DB, et al. Improving the reliability ot stroke subgroup classification using the trial of ORG 10172 in acute stroke treatment (TOAST) criteria. Stroke 2001;32:1091–1097.

    Article  PubMed  CAS  Google Scholar 

  12. Madden KP, Karanjia PN, Adams HP Jr, Clarke WR. Accuracy ot initial stroke subtype diagnosis in the TOAST study. Trial of ORG 10172 in Acute Stroke Treatment. Neurology 1995;45:1975–1979.

    Article  PubMed  CAS  Google Scholar 

  13. Mead GE, Lewis SC, Wardlaw JM, Dennis MS, Warlow CP. How well does the Oxfordshire Community Stroke Project classification predict the site and size of the infarct on brain imaging? J Neurol Neurosurg Psychiatry 2000;68:558–562.

    Article  PubMed  CAS  Google Scholar 

  14. Albers GW, Lansberg MG, Norbash AM, et al. Yield of diffusion-weighted MRI for detection of potentially relevant findings in stroke patients. Neurology 2000;54: 1562–1567.

    Article  PubMed  CAS  Google Scholar 

  15. Lansberg MG, Albers GW, Beaulieu C, Marks MP. Comparison of diffusion-weighted MRI and CT in acute stroke. Neurology 2000;54:1557–1561

    Article  PubMed  CAS  Google Scholar 

  16. Gonzalez RG, Schaefer PW, Buonanno FS, et al. Diffusion-weighted MR imaging: diagnostic accuracy in patients imaged within 6 hours of stroke symptom onset. Radiology 1999;210:155–162.

    PubMed  CAS  Google Scholar 

  17. Oliveira-Filho J, Ay H, Schaefer PW, et al. Diffusion-weighted magnetic resonance imaging identifies the “clinically relevant” penetrator infarcts. Arch Neurol 2000;57:1009–1014.

    Article  PubMed  CAS  Google Scholar 

  18. Ay H, Oliveira-Filho J, Buonanno FS, et al. Diffusion-weighted imaging clarifies a subset of lacunar infarctions associated with embolic source. Stroke 1999;30: 2644–2650.

    Article  PubMed  CAS  Google Scholar 

  19. Lev MH, Farkas J, Rodriguez VR, et al. CT angiography in the rapid triage of patients with hyperacute stroke: accuracy in the detection of large vessel thrombus. J Comput Axial Tomogr 2001;25:520–528.

    Article  CAS  Google Scholar 

  20. Lee LJ, Kidwell CS, Alger J, Starkman S, Saver JL. Impact on stroke subtype diagnosis of early diffusion-weighted magnetic resonance imaging and magnetic resonance angiography. Stroke 2000;31:1081–1089.

    Article  PubMed  CAS  Google Scholar 

  21. Ezzeddine MA, Lev MH, McDonald CT, et al. CT angiography with whole brain perfused blood volume imaging: added clinical value in the assessment of acute stroke. Stroke 2002;33:959–966.

    Article  PubMed  Google Scholar 

  22. Lindley RI, Warlow CP, Wardlaw JM, et al. Interobserver reliability of a clinical classification of acute cerebral infarction. Stroke 1993:24:1801–1804

    Article  PubMed  CAS  Google Scholar 

  23. Zweifler RM, Lyden PD, Taft B, et al. Impact of race and ethnicity on ischemic stroke. The University of California at San Diego Stroke Data Bank. Stroke 1995; 26:245–248.

    Article  PubMed  CAS  Google Scholar 

  24. Sacco RL, Boden-Albala B, Abel G, et al. Race-ethnic disparities in the impact of stroke risk factors: the Northern Manhattan Stroke Study. Stroke 2001:32:1725–1731.

    Article  PubMed  CAS  Google Scholar 

  25. Anderson CS, Taylor BV, Hankey GJ, et al. Validation of a clinical classification for subtypes of acute cerebral infarction. J Neurol Neurosurg Psychiatry 1994;57: 1173–1179.

    Article  PubMed  CAS  Google Scholar 

  26. Sacco RL, Shi T, Zamanillo MC, Kargman DE. Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study. Neurology 1994;44:626–634.

    Article  PubMed  CAS  Google Scholar 

  27. Petty GW, Brown RD Jr, Whisnant JP, et al. Ischemic stroke subtypes: a population-based study of functional outcome, survival, and recurrence. Stroke 2000;31: 1062–1068.

    Article  PubMed  CAS  Google Scholar 

  28. Kolominsky-Rabas PL, Weber M, Gefeller O, Neundoerfer B, Heuschmann PU. Epidemiology of ischemic stroke subtypes according to TOAST criteria: incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study. Stroke 2001;32:2735–2740.

    Article  PubMed  CAS  Google Scholar 

  29. Sacco RL, Foulkes MA, Mohr JP, et al. Determinants of early recurrence of cerebral infarction. The Stroke Data Bank. Stroke 1989;20:983–989.

    Article  PubMed  CAS  Google Scholar 

  30. Berge E, Abdelnoor M, Nakstad PH, Sandset PM. Low molecular-weight heparin vs aspirin in patients with acute ischaemic stroke and atrial fibrillation: a double blind randomised study. HAEST Study Group. Heparin in Acute Embolic Stroke Trial. Lancet 2000;355:1205–1210.

    Article  PubMed  CAS  Google Scholar 

  31. Furlan A, Higashida R, Wechsler L, et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. JAMA 1999;282:2003–2011.

    Article  PubMed  CAS  Google Scholar 

  32. Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of outof-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346: 557–563.

    Article  PubMed  Google Scholar 

  33. Hypothermia After Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549–556. Erratum in: N Engl J Med 2002;346:1756.

    Article  Google Scholar 

  34. Yamauchi H, Fukuyama H, Nagahama Y, et al. Evidence of misery perfusion and risk for recurrent stroke in major cerebral arterial occlusive diseases from PET. J Neurol Neurosurg Psychiatry 1996;61:18–25.

    Article  PubMed  CAS  Google Scholar 

  35. Derdeyn CP, Yundt KD, Videen TO, et al. Increased oxygen extraction fraction is associated with prior ischemic events in patients with carotid occlusion. Stroke 1998;29:754–758.

    Article  PubMed  CAS  Google Scholar 

  36. Derdeyn CP, Videen TO, Simmons NR, et al. Count-based PET method for predicting ischemic stroke in patients with symptomatic carotid arterial occlusion. Radiology 1999;212:499–506.

    PubMed  CAS  Google Scholar 

  37. Chimowitz MI, Kokkinos J, Strong J, et al. The Warfarin-Aspirin Symptomatic Intracranial Disease Study. Neurology 1995;45:1488–1493.

    Article  PubMed  CAS  Google Scholar 

  38. Gomez CR, Orr SC. Angioplasty and stenting for primary treatment of intracranial arterial stenoses. Arch Neurol 2001;58:1687–1690.

    Article  PubMed  CAS  Google Scholar 

  39. Rordorf G, Koroshetz WJ, Ezzeddine MA, et al. A pilot study of druginduced hypertension for treatment of acute stroke. Neurology 2001;56:1210–1213.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Sims, J., Koroshetz, W.J. (2004). Subtypes of Ischemic Stroke. In: Furie, K.L., Kelly, P.J. (eds) Handbook of Stroke Prevention in Clinical Practice. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-769-7_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-769-7_2

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9856-1

  • Online ISBN: 978-1-59259-769-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics