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Differential Diagnosis And Prognostic Markers Of Stroke

Stroke as the most common sequel of decreased cerebral blood flow due to embolic or thrombolytic occlusion of cerebral arteries leads to an acute state in the neurologic patient. Laboratory diagnosis along with noninvasive examinations such as computed tomography, color Doppler and nuclear magnetic resonance provides basic data for timely recognition and management of patients with acute cerebrovascular disturbance. Although the neuroimaging techniques enable almost all diagnoses of neurologic disease, laboratory findings remain a sensitive indicator of the current state of an individual allowing for identification of pathologic findings, assist in reaching the diagnosis, are useful in therapeutic success monitoring, and enable the disease outcome to predict. Laboratory diagnosis in patients with acute neurologic disturbance includes simultaneous examination of the blood, urine and cerebrospinal fluid (CSF). Analysis of CSF provides valuable information for the differential diagnosis of stroke, primarily to distinguish between ischemia and hemorrhage, and assists in recognizing artificial, puncture induced hemorrhage and other neurologic diseases such as meningitis, abscess, metastases, etc., that may be masked as a cerebrovascular disease. The cytologic and biochemical analyses of CSF indicate the stage of pathologic process, size of lesion, and metabolic status of cerebral tissues. Analysis of CSF, which should be done within the shortest possible time, includes physical examination, cytologic examination, i.e. determination of cell count and type, and hematogenous pigment examination. Additional CSF analysis includes determination of protein content, glucose and lactate concentrations, and electrolytes.

Neurological Diseases

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