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Associated symptoms

  • Fever raises the suspicion of endocarditis and resulting embolic stroke

  • Infections activate acute phase blood reactants, thereby predisposing to thrombosis

  • Severe headache at the onset of neurologic symptoms favours SAH, while headache that develops after symptom onset that is accompanied by gradually increasing

    neurologic signs, decreased consciousness, and vomiting is most often indicative of ICH. Some patients have headaches in the prodromal period before thrombotic strokes. A prior history of intermittent severe headaches that are instantaneous in onset, persist for days, and prevent daily activities often reflects the presence of an aneurysm.

  • Vomiting is common in patients with ICH, SAH, and posterior circulation large artery ischemia.

  • Seizures are most often seen in patients with lobar ICHs or brain embolism, they are rare in patients with acute thrombosis.

  • Reduced alertness favours the presence of hemorrhage. Accompanying neurologic signs are suggestive of ICH, while the absence of focal signs suggest SAH. Loss of consciousness is also common in patients with thrombotic and embolic strokes that are large or involve the posterior circulation large arteries.

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