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Identify factors which may influence management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The objectives of identifying stroke risk factors are:

  • to identify specific pathophysiological subtypes of cerebral infarction with different management and prognosis
  • to ascertain specific risk factors and their possible prevention

Investigations that might contribute to these goals include:

  • chest X-ray - cardiac enlargement in hypertension or valvular disease
  • retinal examination - retinopathy in hypertension, embolic disease
  • ECG - ventricular enlargement and/or arrhythmias in hypertensive/embolic disease; recent MI in embolic disease; conduction defect - embolic / output failure
  • blood glucose - for hyperglycaemia in diabetes mellitus
  • serum cholesterol and lipids - hyperlipidaemia in patients under 65 years
  • ESR, auto-antibodies - for vasculitis, collagen vascular disease
  • full blood count - for polycythaemia, thrombocytopenia
  • urine analysis - polyarteritis, thrombocytopenia
  • other haematological tests as indicated - e.g. neurosyphilis
  • cervical spine X ray - for atlanto-axial subluxation
  • note drug history - oral contraceptives, amphetamines, opiates

Further investigations as indicated:

  • blood culture - if suspected infective endocarditis
  • sickle cell screen, plasma electrophoresis, viscosity studies

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