From Penumbra to Prevention — Master the Full ABPN Vascular Neurology Blueprint

Built on the mechanisms that drive every stroke treatment decision — autoregulatory failure, penumbral salvage, thrombus composition, and collateral hemodynamics — this board review connects cerebrovascular pathophysiology to the clinical reasoning tested on the ABPN Vascular Neurology certification examination. Twenty-four chapters move from vascular neuroanatomy and neurovascular diagnostics through the full spectrum of ischemic, hemorrhagic, and venous stroke, then into neurocritical care, secondary prevention, rehabilitation, and the non-vascular topics that round out the blueprint. A 220-question Comprehensive Mock Exam mirrors the official format, domain weighting, and question style, with full rationales immediately following every question — chapter by chapter and exam-wide.

What This Book Puts in Your Hands

• Localize ischemic stroke by vascular territory — cortical branch syndromes, watershed patterns, lacunar presentations, and posterior circulation localizations mapped to their specific arterial supply
• Apply the DAWN and DEFUSE 3 imaging-selection criteria for extended-window thrombectomy, and distinguish alteplase from tenecteplase protocols for acute reperfusion
• Manage ICH blood pressure targets (INTERACT2, ATACH-2), agent-specific anticoagulant reversal (4F-PCC, idarucizumab, andexanet alfa), and surgical indications including cerebellar emergencies
• Recognize SAH complications by timeline — rebleeding risk, vasospasm surveillance with TCD and Lindegaard ratio, nimodipine neuroprotection, and DCI rescue therapy
• Diagnose CVT even with hemorrhagic infarction, apply anticoagulation confidently, and distinguish RCVS from PACNS by clinical course and CSF findings
• Identify monogenic stroke disorders — CADASIL imaging hallmarks, Fabry enzyme assays, sickle cell TCD screening thresholds, and MELAS non-territorial stroke-like episodes
• Select mechanism-specific secondary prevention — DAPT duration (CHANCE, POINT), DOAC trials for AF (ARISTOTLE, RE-LY), ESUS evidence (NAVIGATE-ESUS), and pioglitazone for insulin resistance (IRIS)
• Separate stroke mimics from true cerebrovascular events at the bedside — Todd paralysis, migraine with aura, hypoglycemia, and PRES — using the DWI-FLAIR mismatch and HINTS examination

Prepare with the same mechanism-to-management reasoning the ABPN examination demands — and carry it forward to every stroke patient you treat.