Foundations of Stroke Care: Understanding Classification and Clinical Presentation

Welcome back to another AJMC Peer Exchange series. In this episode titled, ‘Foundations of Stroke Care: Understanding Classification and Clinical Presentation’, Mark Makhinson led the conversation about the following questions:

What are the different types of stroke and do each present themselves in patients?

How are cardioembolic ischemic strokes different from those that are non-cardioembolic?

Andrew Russman, Danison Emmerson, and David Rose highlighted the critical distinctions between ischemic stroke and hemorrhagic stroke, noting that focal neurologic deficits often characterize ischemic events while severe headaches are more common in hemorrhagic presentations. The experts discussed the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification system, which categorizes ischemic strokes into subtypes such as large artery atherosclerosis, cardioembolism, and small vessel occlusion. The panel emphasized the importance of identifying specific etiologies, such as atrial fibrillation (AF) or arterial dissection, to tailor clinical investigations. Furthermore, the conversation framed how understanding these foundational classifications is essential for transitioning from acute diagnosis to effective long-term management.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

In the next episode, ‘The Societal Impact of Stroke: Prevalence, Pathophysiology, and Economic Burden’, panelists will continue their discussion on stroke and highlight the prevalence of various stroke subtypes, the "Fab Five" modifiable risk factors, and the significant $70 billion annual economic burden the disease places on the healthcare system.