[Transition and current state of the classification and diagnostic strategy in the ischemic stroke]

Since 1990, the classification of cerebrovascular disease released from the NINDS has been used. The subtypes of ischemic stroke have been diagnosed based on the diagnostic criteria used in the TOAST. For classifying the subtypes of ischemic stroke, we need to know the size and location of the infarcts and the presence of the stenosis or occlusion in the stem arteries. The cardiac evaluation including the long-term ECG monitor should be done for excluding the embolic source. Although the branch atheromatous disease (BAD) is not recognized in the western countries, it should be established as one clinical entity because of the high incidence rate in Japan.