Ischemic Stroke
What is the cause of my patient’s stroke?
Match the tool to the suspected stroke mechanism: use ASCOD or ESUS to classify etiology, RoPE and PASCAL to evaluate PFO-related stroke, and ASCVD to guide long-term vascular risk reduction.
Algorithm
Diagnosis
ASCOD Algorithm for Ischemic Stroke
A structured way to evaluate multiple, possible stroke etiologies
Use this tool when
Multiple potential stroke etiologies are being considered
Algorithm
Prognosis
ASCVD (Atherosclerotic Cardiovascular Disease) Risk Algorithm including Known ASCVD from AHA/ACC
10-year cardiovascular risk estimate to guide treatment decisions
Use this tool when
Planning long-term vascular risk reduction after stroke or TIA
Diagnosis
Risk of Paradoxical Embolism (RoPE) Score
Likelihood PFO is causative vs. incidental
Use this tool when
Considering patent foramen ovale (PFO) as a stroke etiology
Prognosis
PFO-Associated Stroke Causal Likelihood (PASCAL) Classification System
Estimate of benefit for stroke prevention with PFO closure
Use this tool when
Considering intervention for PFO in stroke prevention
Diagnosis
Embolic Stroke of Undetermined Source (ESUS) Criteria
Framework for embolic stroke classification
Use this tool when
No clear stroke source