Classification of Stroke According to Toast Criteria

Abstract

Ischemic strokes constitute more than 80% of stroke patients. The appropriate classification of patients with ischemic stroke is essential for the selection and prognosis of treatment. Stroke is a heterogeneous disease caused by vascular, cardiac, hematologic, and systemic pathologies. Identifying the most probable underlying cause will determine the right approach. Additionally, the appropriate classification will allow for selecting the right patient groups for epidemiologic and clinical studies, thus understanding the pathophysiologic processes. The "Trial of Org 10172 in Acute Stroke Treatment" (TOAST) classification has been the most widely used approach for many years, although numerous categorization methods for ischemic strokes have been presented. With the TOAST classification, for the first time, the main groups of ischemic stroke were identified using specific pathophysiology criteria. This classification divides ischemic stroke into five major groups: large artery atherosclerosis, cardioembolism, small vessel occlusion (lacunar infarction), stroke caused by another known cause, and stroke of unknown cause. The diagnosis is based on clinical features and information from tests such as brain imaging (computed tomography/magnetic resonance imagining), cardiac imaging (echocardiography, etc.), duplex imaging of extracranial arteries, arteriography, and laboratory tests for conditions such as predisposition to thrombosis. © 2024 Nova Science Publishers, Inc. All rights reserved.