[The clinical diagnosis of ischemic stroke: an update]

The incidence of ischemic stroke has been increasing in recent years. It is important to promptly distinguish stroke from stroke mimics and to make a correct diagnosis of the subtype of ischemic stroke, such as atherothrombosis, cardiac embolism, small vessel disease, and other causes. An accurate diagnosis should be made with a detailed clinical history, a neurological examination, and an evaluation of the site and size of the lesion with computed tomography or magnetic resonance imaging. For vascular evaluations, magnetic resonance angiography, computed tomographic angiography, and ultrasonography, including carotid echography and transcranial Doppler, are ideal and noninvasive. Transesophageal echocardiography and continuous cardiac monitoring should be performed in patients with embolisms from unknown sources. In this article, we describe the classifications of ischemic stroke and the clinical features of each subtype, and we provide an overview on the recent progress that has been made in diagnostic tools.