Snapshot A 55-year-old woman presents to the emergency department after developing slurred speech approximately 2 hours ago. Once she arrived, her symptoms gradually resolved. CT head without contrast and CT angiography was unremarkable. MRI brain with diffusion weighted sequences does not provide evidence of ischemia. An electrocardiogram demonstrates an irregularly irregular rhythmn with absence of P-waves, concerning for atrial fibrillation. She was admitted for an expedited work-up, which demonstrate left atrial dilation on transesophageal echocardiography. Introduction Definition login to view 1 more bullet Epidemiology Risk factors login to view 7 more bullets Etiology Cryptogenic (no clear source) Atheroemboli Vertebral artery stenosis Cardiogenic emboli login to view 1 more bullet Hypercoagulable/hyperviscious states (e.g., leukemia and sickle cell disease) Presentation Symptoms/physical exam login to view 2 more bullets Imaging MRI brain login to view 3 more bullets Intracranial non-invasive vessel imaging login to view 6 more bullets Studies Electrocardiogram login to view 1 more bullet Differential Acute ischemic stroke login to view 2 more bullets Treatment Medical login to view 13 more bullets Operative login to view 3 more bullets Compications Acute ischemic stroke Prognosis ABCD2 score login to view 2 more bullets Patients are at high risk for recurrent TIAs and developing stroke