NEUROLOGISTS OF the 19th and first half of the 20th centuries were masters of scrupulous neurological examination. Based on the exactitudes of an exquisitely detailed physical examination, neurologists attempted the precise location of a deficit. The apparent location of the lesion, in association with its mode of temporal development and patient characteristics such as age, sex, race, and history, produced a differential diagnosis. Imaging methods, crude by modern standards, and relatively primitive laboratory testing were directed by the history and physical signs. These techniques provided provisional diagnoses.
Barnett HJM. A Modern Approach to Posterior Circulation Ischemic Stroke. Arch Neurol. 2002;59(3):359-360. doi:10.1001/archneur.59.3.359