Many patients will have had brain imaging in the acute setting to exclude stroke mimics and to include stroke chameleons (stroke initially thought to be an alternative diagnosis). About 15% to 25% of patients thought to have stroke on clinical grounds will be given an alternative diagnosis with the help of About 13% of patients with stroke or TIA thought to have a nonstroke diagnosis for their neurological symptoms will be given the diag- nosis of stroke with the help of brain imaging.52,53 A prospective, multicenter multinational study showed that, in patients with recent minor focal nonmotor, nonspeech neurological deficits, diffusion-weighted MRI detected acute infarction in 13.5% and that this finding had prognostic relevance because detection of infarction was associated with a >6-fold increase in the risk of recurrent stroke at 1 year.85 5. As reported in this guideline, control of hyperten- sion (Section 4.2), blood glucose (Section 4.4), and lipids (Section 4.3) have been proven effective for reducing the risk of ischemic stroke; thus, assess- ment of whether the patient is at therapeutic goal for these metabolic parameters helps to optimize therapy. Fasting is not routinely required for lipid testing because the lipid profile components under fasting and nonfasting conditions differ in non- clinically significant degrees (the exception being patients with nonfasting triglycerides of >440 mg/dL, who should have fasting levels drawn).86 HbA1c determination can detect new cases of type 2 diabetes (T2D) in 11.5% of patients pre- senting with acute ischemic stroke and prediabe- tes in 36.2%.54 Abnormal blood testing can help to stratify risk so that physicians can concentrate efforts of prevention on those at highest risk. 