Purpose of review: Recent trends in the practice of stroke neurology lay a strong and excessive reliance on data generated from large epidemiological and clinical trials to direct patient care. This article highlights some of the pitfalls of this approach. It discusses the continuing importance of identifying stroke syndromes in implementing individualized patient care.
Recent findings: Stroke is a heterogeneous disease and occurs through a variety of mechanisms. With the help of examples, the article illustrates some of the complexities of clinical decision making in an individual patient. Some important recent advances in the diagnostic and treatment armamentarium for stroke are also discussed.
Summary: Identification of stroke syndromes remains an important tool in the rational management of stroke patients.