Clinical meaning
Ischemic stroke results from cerebral artery occlusion (thrombotic or embolic) causing neuronal death from ATP depletion. The ischemic penumbra (tissue at risk surrounding the core infarct) is salvageable with reperfusion. IV alteplase within 4.5 hours (NINDS, ECASS III) or mechanical thrombectomy within 24 hours for large vessel occlusion (DAWN, DEFUSE 3). NIHSS quantifies severity. Door-to-needle time target <60 minutes.
Diagnosis & workup
Diagnostics & workup: - Specific autoantibody panels (AChR, anti-MOG, anti-NMDA receptor) - NIH Stroke Scale (NIHSS) for stroke severity quantification - Glasgow Coma Scale (GCS) for consciousness level assessment - Genetic testing when hereditary neurological condition suspected - Visual field testing and fundoscopic exam for papilledema - MRI brain with/without gadolinium (ischemia, demyelination, tumors) - Neuropsychological testing for cognitive domain assessment
Risk factors: - Occupational toxin exposure (heavy metals, organophosphates) - Tobacco use with cerebrovascular disease risk - Atrial fibrillation with cardioembolic stroke risk - Prior CNS infection (increased seizure risk) - Chronic migraine with aura (increased stroke risk in women on OCPs) - Hypertension (leading modifiable risk for stroke) - Obesity and metabolic syndrome with neuroinflammation