Unusual stroke syndromes
Brainstem and thalamic syndromes that are easy to miss, and the uncommon causes of stroke in younger adults (dissection, venous thrombosis, RCVS, CADASIL, moyamoya, vasculitis, Fabry disease), with the test and first treatment for each.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Two groups are tested: brainstem and thalamic syndromes that don't look like a typical stroke, and uncommon causes of stroke, especially in people under 50.
- Posterior circulation strokes are missed more often than anterior ones. Vertigo, diplopia, reduced consciousness and ataxia can be the only signs.
- In young stroke, think dissection, PFO, venous thrombosis, RCVS, drugs (methamphetamine), antiphospholipid syndrome and genetic arteriopathy. The standard work-up and reperfusion are in Ischaemic stroke.
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Sources
- Australian and New Zealand Living Clinical Guidelines for Stroke ManagementAU/NZStroke Foundation, Living guideline, acute updates September 2025 and April 2026
- 2026 Guideline for the Early Management of Patients With Acute Ischemic StrokeAmerican Heart Association/American Stroke Association (Stroke), 2026
- Saposnik G, Bushnell C, Coutinho JM et al. Diagnosis and management of cerebral venous thrombosis: a scientific statement from the American Heart Association. Stroke 2024;55:e77-e90American Heart Association (Stroke), 2024
- Yaghi S, Engelter S, Del Brutto VJ et al. Treatment and outcomes of cervical artery dissection in adults: a scientific statement from the American Heart Association. Stroke 2024;55:e91-e106American Heart Association (Stroke), 2024
- Rocha EA et al. RCVS2 score and diagnostic approach for reversible cerebral vasoconstriction syndrome. Neurology 2019;92:e639-e647Neurology, 2019
- PBS item 14573B: migalastat (Galafold) 123 mg capsule, General Schedule, Authority Required, Fabry diseaseAU/NZPharmaceutical Benefits Scheme, Australian Government, Accessed November 2026
- Last updated
- 14 November 2026
What changed
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