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Stroke - Coggle Diagram

- - - - Bacterial
        
        Neurosyphilis
        
        TB meningitis
      - Viral
        
        HIV vasculopathy
        
        HSV vasculitis
        
        VZV vasculitis
        
        COVID-19?
      - Fungal
        
        Cryptococcal meningitis
      - Parasitic
        
        Chagas
        
        Malaria
    - - HIV
      - VDRL/ TPHA
      - CSF study
  - - - Sickle cell disease
      - Prothrombotic disorders
      - Malignancy
    - - ANA, C3, C4, Anti-ds DNA
      - Lupus anticoagulant & Anticardiolipin antibodies
      - Protein C/S, Antithrombin III
      - TSH, free T4
      - CBC, PT/aPTT, Fibrinogen
  - - - Atherosclerotic
        
        Alcohol
        
        Smoking
        
        Obese
        
        Coffee
        
        Dyslipidemia
      - Non-atherosclerotic vasculopathy
        
        Moyamoya disease
        
        Focal cerebral arteriopathy
        
        Vasculitis
        
        Craniocervical dissection
        
        CADASIL
        
        Migraine
    - - HbA1c, Lipid profile
      - Brain MRI/MRA/MRV
      - Brain CT, CT angiogram
      - Cerebral angiogram
      - Carotid/ Transcranial ultrasound
  - - - Homocystinuria
      - Menkes disease
      - Fabry disease
      - ADA2 deficiency
    - - Alpha-gal activity
      - Lyso-Gb3
  - - - Structural
        
        PFO
        
        Atrial septal aneurysm
        
        Rheumatic cardiac disease
      - Arrthymia
        
        AF
    - - Echocardiograph (TTE,TEE)
      - EKG
      - Holter
  - - - Mitochondrial disorders
      - Substance abuse
    - - Urine drug screen
- - - - Common syndromes
        
        Sensorimotor stroke
        
        Clinical features
        
        Pure motor+ pure sensory
        
        Possible location
        
        Post. limb of IC
        
        VPL of thalamus
        
        thalamic somatosensory radiation
        
        Ataxic hemiparesis
        
        Clinical features
        
        Dysarthria
        
        Ataxia
        
        Contralateral F, A, L hemiparesis
        
        No sensory, visual disturbance
        
        Possible location
        
        Post. limb of IC
        
        Ventral pons
        
        Corona radiata
        
        Cerebral peduncle
        
        Basal ganglia lacune
        (Dysarthria-clumsy hand syndrome)
        
        Clinical features
        
        Usually asymptomatic
        
        Contralateral Hemiballismus
        
        Dysarthria／Dysphagia
        
        Contralateral hand loss of fine motor control
        (clumsy hand)
        
        Possible location
        
        Caudate
        
        Putamen
        
        Globus pallidus
        
        Subthalamic nucleus
        
        Pure motor hemiparesis 
        
        Clinical features
        
        Contralateral F, A, L hemiparesis
        
        No sensory, visual disturbance
        
        Dysarthria
        
        Possible location
        
        Corona radiata
        
        Cerebral peduncle
        
        Ventral pons
        
        Post. limb of IC
        
        Pure sensory stroke
        
        Clinical features
        
        Contralateral F, A, L numbness/ paresthesia
        
        No motor dysfunction
        
        No language disturbance
        
        Possible location
        
        VPL of thalamus
      - Definition
        
        Occlusion of a single penetrating branch
        of a large cerebral artery
        
        Without cortical signs
        
        No aphasia
        
        No agnosia
        
        No neglect
        
        No apraxia
        
        No hemianopsia
        
        Small infarction
        (2 to 15 mm in diameter)
        
        MRI< 2cm
        
        CT< 1.5cm
- - - - Posterior MCA cortex (M3)
      - Anterior cortex immediately rostal to M1 (M4)
      - MCA cortex lateral to the insular ribbon (M2)
      - Lateral cortex immediately rostal to M2 (M5)
      - Anterior MCA cortex (M1)
      - Posterior cortex immediately rostal to M3 (M6)
      - Insular Ribbon
    - - Caudate
      - Internal capsule
      - Lentiform nucleus
  - - - Effacement of adjacent sulci and ventricle
      - Midline shifting
      - Effacement of sulci
      - Uncal hernation
- - - - T2
      - T2 FLAIR
      - DWI
    - - ADC
      - T1
  - - - T2
      - T2 FLAIR
      - DWI
      - ADC
    - - T1
  - - - T2 (6hrs)
      - T2 FLAIR (6hrs)
      - DWI (mins)
    - - ADC (mins)
      - T1 (16hrs)
  - - - ADC
      - T2
      - T2 FLAIR
    - - DWI
      - T1
- - - - Contralateral PPRF
        
        Ipsilateral CN6
        
        Lateral rectus
        
        MLF
        
        Contralateral CN3
        
        Medial rectus