When evaluating ischemic strokes, suspect an artery-to-artery embolism if multiple infarcts of varying ages are confined to a single vascular territory. For cases meeting ESUS criteria, note that definitive superiority between anticoagulation and antiplatelet therapy remains unestablished. When carotid dissection is suspected following neck trauma or hyperextension, look closely for the classic clinical presentation of unilateral headache and partial Horner syndrome.

Differing-aged infarcts in one vascular territory imply an artery-to-artery embolic source.

ESUS represents a non-lacunar brain infarct lacking a clear major cardiac source.

Carotid dissection classically presents with one-sided headache, stroke/TIA, and partial Horner syndrome.

Carotid dissections commonly stem from trauma involving hyperextension or rapid deceleration.