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Can Embolic Stroke Be Diagnosed on the Basis of Neurologic Clinical Criteria?
Manuel Ramirez-Lassepas, MD;
Robert J. Cipolle, PharmD;
Randall J. Bjork, MD;
Jeffrey Kowitz, MD;
Bruce D. Snyder, MD;
Jan C. Weber, MD;
Steven D. Stein, MD
Arch Neurol. 1987;44(1):87-89.
Abstract
• Diagnosis of embolic stroke is based on identification of a source of embolus (SOE) and on neurologic symptoms acknowledged as "clinical criteria." To test the validity of these criteria, we analyzed the symptoms at onset in 193 patients hospitalized after acute cerebral infarction. Patients were grouped according to identification of a cardiac SOE (106 patients), an arterial SOE (38 patients), or no SOE (49 patients). Cross-tabulations demonstrated that only rapidity and loss of consciousness at onset were associated with the presence of a cardiac SOE to a significant degree. Although these symptoms were highly specific for cardiac SOE, they were not sensitive. A distinct clinical neurologic profile from the symptoms and mode of onset was not identified.
Author Affiliations
From the Department of Neurology, St Paul-Ramsey Medical Center and University of Minnesota School of Medicine, St Paul (Drs Ramirez-Lassepas, Bjork, Kowitz, Snyder, Weber, and Stein); and the Department of Pharmacy Practice, University of Minnesota College of Pharmacy, Minneapolis (Dr Cipolle).
Footnotes
Accepted for publication Aug 4, 1986.
Read in part before the Third International Brain-Heart Conference, Trier, West Germany, Sept 7, 1985.
Reprint requests to Department of Neurology, St Paul-Ramsey Medical Center, 640 Jackson St, St Paul, MN 55101 (Dr Ramirez-Lassepas).
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