Acute stroke is the acute onset of focal neurological deficits in a vascular territory affecting the brain, retina, or spinal cord due to underlying cerebrovascular diseases. Stroke is prevalent across patient populations and can significantly cause morbidity and mortality. Strokes are categorized as ischemic and hemorrhagic. Hemorrhagic strokes can further be classified as intracerebral and subarachnoid hemorrhage. Among ischemic strokes, the Trial Org 10172 in Acute Stroke Treatment (TOAST) classification is used to subdivide the categories that include the following:
Cardioembolism
Small vessel occlusion
Large artery atherosclerosis
Stroke of undetermined etiology
Stroke of other determined etiology (possible or probable depending on the results of ancillary studies)
A crucial aspect of classification involves the physician's ability to designate a specific subtype diagnosis as probable or possible, depending on the level of certainty. A diagnosis is considered "probable" when clinical findings, neuroimaging data, and results of diagnostic studies align with a particular subtype, and other potential causes have been ruled out. On the other hand, a diagnosis is labeled as "possible" when clinical findings and neuroimaging data suggest a specific subtype, but additional studies have not been conducted. Given that many patients undergo a limited number of diagnostic tests, the categorizations of probable and possible allow the physician to establish as precise a subgroup diagnosis as possible.
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