Abstract
Patients with stroke mimics (SM), i.e. conditions with stroke-like symptoms, may risk harm if treated with intravenous thrombolysis (IVT). Current guidelines state low risk of intracerebral hemorrhage based on studies comprising a total of <400 SM cases. We aimed to compare safety and outcomes following IVT between patients with acute ischaemic stroke and mimicking conditions. We included IVT-treated ischaemic stroke patients in the SITS International Stroke Thrombolysis Register 2003-2017, examined with magnetic resonance imaging 22-36 h after treatment. Outcomes were parenchymal hematoma (PH) after treatment, symptomatic intracerebral hemorrhage (SICH) per Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS-MOST), Second European Co-operative Stroke Study (ECASS II) and National Institutes of Neurological Disorders and Stroke Study (NINDS) criteria, death and modified Rankin Scale score (mRS) at 3 months. Of 10 436 patients, 429 mimics (4.1%) were identified. The most common types were functional (30.8%), migraine (17.5%) and seizure (14.2%). Patients with mimics had fewer cerebrovascular risk factors and lower median National Institutes of Health Stroke Scale score [7 (interquartile range, 5-10) vs. 8 (5-14)...Continue Reading
References
Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Oct 27, 1998·Lancet·W HackeP Trouillas
Jan 30, 2007·Lancet·Nils WahlgrenUNKNOWN SITS-MOST investigators
Jan 24, 2009·Stroke; a Journal of Cerebral Circulation·David T WinklerStefan T Engelter
Nov 7, 2009·Cerebrovascular Diseases·Ken UchinoMaxim D Hammer
Mar 26, 2010·Neurology·O Y ChernyshevS I Savitz
Apr 16, 2011·Stroke; a Journal of Cerebral Circulation·Georgios TsivgoulisJames L Frey
Jul 1, 2011·Neurology·D StrbianUNKNOWN Helsinki Stroke Thrombolysis Registry Group
Jan 11, 2012·Journal of Neurology·A FörsterR Kern
Mar 24, 2012·Stroke; a Journal of Cerebral Circulation·Michael MazyaUNKNOWN SITS Investigators
Feb 2, 2013·Stroke; a Journal of Cerebral Circulation·Edward C JauchUNKNOWN Council on Clinical Cardiology
Feb 28, 2013·Stroke; a Journal of Cerebral Circulation·Sanne M ZinkstokPaul J Nederkoorn
Aug 10, 2013·Stroke; a Journal of Cerebral Circulation·Paul J NederkoornStefan T Engelter
Aug 12, 2014·Lancet·Jonathan EmbersonUNKNOWN Stroke Thrombolysis Trialists' Collaborative Group
Mar 21, 2015·Stroke; a Journal of Cerebral Circulation·Georgios TsivgoulisAndrei V Alexandrov
Jul 1, 2015·Neurology. Clinical Practice·Ava L LibermanShyam Prabhakaran
Oct 31, 2015·Circulation. Cardiovascular Quality and Outcomes·Nadim AnaniTiago Prazeres Moreira
Dec 24, 2015·Stroke; a Journal of Cerebral Circulation·Bart M DemaerschalkUNKNOWN American Heart Association Stroke Council and Council on Epidemiology and Prevention
May 14, 2016·Stroke; a Journal of Cerebral Circulation·Charith CoorayNiaz Ahmed
Oct 5, 2016·Clinical Medicine : Journal of the Royal College of Physicians of London·Ang DawsonBarry J Moynihan
Nov 1, 2017·BMJ Open·Nikolaos KostulasDavid Nathanson
Apr 23, 2019·European Stroke Journal·Michael V MazyaNiaz Ahmed
Citations
Dec 6, 2018·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Noreen KamalJennifer Bestard
Nov 5, 2019·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
Jan 10, 2020·Stroke; a Journal of Cerebral Circulation·Boris KeselmanMichael V Mazya
Apr 17, 2020·Stroke; a Journal of Cerebral Circulation·Stoyan PopkirovAlastair M Buchan
Jul 31, 2019·Current Pain and Headache Reports·Oleg Otlivanchik, Ava L Liberman
Aug 16, 2019·Circulation. Cardiovascular Quality and Outcomes·William J Meurer, Lesli Skolarus
Jun 23, 2020·Stroke; a Journal of Cerebral Circulation·Brian Mac GroryMatthew Schrag
Jan 23, 2020·Arquivos de neuro-psiquiatria·Didier LeysPatrick Goldstein
Jun 9, 2020·Frontiers in Neurology·Håkan AlmqvistMichael V Mazya
Jul 9, 2020·BMC Neurology·Tian Ming TuHoon Chin Lim
Oct 23, 2020·Neurology·Kosmas MachaTobias Engelhorn
Feb 6, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Klearchos PsychogiosGeorgios Tsivgoulis
Mar 9, 2021·Annals of Medicine·Brian H BuckAshfaq Shuaib
Mar 20, 2021·Therapeutic Advances in Neurological Disorders·Georgios TsivgoulisAndrei V Alexandrov
Apr 1, 2021·Expert Review of Neurotherapeutics·Shadi El-WahshCandice Delcourt
Apr 4, 2021·Journal of Clinical Medicine·Jordi Kühne EscolàJan C Purrucker
Feb 21, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Alicia Gonzalez-MartinezJosé Vivancos
Sep 10, 2021·Acta Neurologica Scandinavica·Mathias BarraHalvor Naess
Dec 5, 2021·Headache·Alicia Gonzalez-MartinezJosé Vivancos
Nov 21, 2021·Current Opinion in Neurology·Klearchos Psychogios, Georgios Tsivgoulis
Jan 14, 2022·Acta neurologica Belgica·Feifeng LiuLian Zuo