Neurological examination, rather than vascular risk factor assessment, serves to distinguish strokes from stroke mimics

World Neurosurgery
Jessica E MarotSeon-Kyu Lee

Abstract

Stroke mimics takes upto 30% of patients presenting with stroke-like symptoms. We aim to evaluate the stroke mimic rate and to identify factors that may differentiate stroke mimics from real strokes in a population with a high prevalence of vascular risk factors. From January 1st to December 31st 2013, patients who had Stroke Alert activations were retrospectively reviewed. Stroke mimics were defined as patients who had Stroke Alert activation, but the discharge ICD-9 codes did not include the diagnosis of ischemic stroke, hemorrhagic stroke, or transient ischemic attack. Demographics, clinical history, laboratory data, neurologic examinations, Acute Stroke Scales were analyzed in univariate and multiple logistic regression analyses. In 368 Stroke Alert activations, 184 (50%) were stroke mimics. Common causes of strokes mimics were seizure disorders (11.4%), and other malaise and fatigue (4.9%). 93% of patients for whom a Stroke Alert was activated had at least one vascular risk factor. Univariate analysis found that seizure history, seizure at onset, negative findings on neurological exam, and lower scores on three different stroke scales/screen were associated with stroke mimic. Multiple logistic regression analysis showed th...Continue Reading

Citations

Feb 6, 2021·International Journal of General Medicine·Ajay Kumar MishraKamal Kant Sahu

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