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1. Neurologic symptoms often occur during sleep in a slow, stepwise progression (termed "stroke in evolution").

2. LOC is rare except when the area of infarction is large or brainstem is involved.

3. 50% patients have a history of TIAs in the same distribution as the presenting symptoms of their stroke.

4. Rarer causes of thrombosis are lupus anticoagulant, polycythemia, meningovascular syphilis, dissecting aortic aneurysm, and thrombocytosis.

5. Emboli from incompletely thrombosed artery may precipitate an abrupt deficit.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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