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World J Clin Cases. Jun 16, 2017; 5(6): 191-202
Published online Jun 16, 2017. doi: 10.12998/wjcc.v5.i6.191
Complementary examinations other than neuroimaging and neurosonology in acute stroke
Adrià Arboix, Víctor Obach, Maria José Sánchez, Joan Massons
Adrià Arboix, Maria José Sánchez, Joan Massons, Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, University of Barcelona, E-08029 Barcelona, Spain
Víctor Obach, Acute Stroke Unit, Department of Neurology, Hospital Clínic, University of Barcelona, E-08029 Barcelona, Spain
Author contributions: Arboix A designed the research, performed the Pubmed bibliographic research, analyzed data and wrote the paper, he is also the corresponding author; Obach V and Massons J conducted the literature review and prepared the tables and provided input in writing; Sánchez MJ contributed to write the paper, edited the manuscript and provided editorial assistance; all have read and approved the final version to be published.
Conflict-of-interest statement: None to be declared.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Adrià Arboix, MD, PhD, Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, University of Barcelona, C/Viladomat 288, E-08029 Barcelona, Spain. aarboix@hscor.com
Telephone: +34-93-4948940 Fax: +34-93-4948906
Received: January 17, 2017
Peer-review started: January 19, 2017
First decision: March 8, 2017
Revised: March 21, 2017
Accepted: April 6, 2017
Article in press: April 10, 2017
Published online: June 16, 2017
Processing time: 147 Days and 17.9 Hours
Abstract

The etiologic diagnosis of cerebrovascular diseases requires non-routine complementary examinations to be performed. Thus, in specific cases, after neuroimaging (computed tomography/magnetic resonance imaging cerebral scan sequences) and neurosonology (Doppler test of the supra-aortic trunks, transcranial echography and echocardiography), which academically allow us to classify the patients according to their etiologic stroke subtype, further examinations must be used to make a correct etiologic diagnostic. The present review aims to update knowledge about the usefulness of the different tests of blood and urine, plain chest radiography, X-ray of the spine, skull and abdomen, lumbar puncture, electroencephalography, evoked potentials, polysomnography, and pathologic examination after biopsy of the artery, skin, muscles, nerves, meninges, and brain, in the management of patients who have suffered an acute stroke.

Keywords: Complementary examinations; Cerebrovascular disorders; Acute stroke; Diagnostic techniques; Blood biochemistry; Polysomnography

Core tip: In selected cases of acute stroke, some complementary examinations (different from neuroimaging, neurosonology and cardiac tests) are needed for the adequate etiological diagnosis. For example, the polysomnographic study allows for the diagnosis of respiratory sleep disorders; urinalysis may rule out the presence of toxins related to stroke; the analysis of the cerebrospinal fluid eliminates the possibility of an infection or an inflammatory process of the central nervous system and the artery biopsy lets you diagnose inflammatory arteritis. The knowledge of the diagnostic performance of these complementary examinations, which are sometimes true diagnostic tests, is very useful in the daily clinical practice of stroke patients.