Talks
Presentation Type
Oral Presentation
Discipline Track
Patient Care
Abstract Type
Research/Clinical
Abstract
Background: Stroke is defined as an acute neurologic injury that is the result of a disruption in cerebral perfusion due to the blockage or rupture of an artery. Ischemic infarcts represent up to 87% of all strokes, and most commonly present with sudden onset, focal neurologic deficits that are consistent with a vascular etiology. Approximately 30% of patients presenting to the Emergency Department with stroke-like symptoms are unfortunately stroke mimics.
Stroke mimics such as syncope, sepsis, seizure, and migraines can present with stroke-like symptoms and are often indistinguishable from true strokes. The study conducted will serve to provide medical residents and medical students with a clearer understanding of such stroke mimics in the hospital setting.
Methods: The data collected through a retrospective chart review of 100 consecutive patients who were admitted to Valley Baptist Medical Center Harlingen with a provisional diagnosis of stroke. The information will be de-identified to protect the privacy of the patients. All eligible candidates, age 18 years and over, were considered regardless of race or gender.
Results: Our chart review included 85 patients presenting with stroke-like symptoms. Of these, 27 patients (31.8%) were found to be CVA mimics, while 58 patients (68.2%) were ischemic strokes or TIA.
Stroke mimics with the highest frequency in our study were migraines (5 cases, 18.5%), syncope/presyncope (2 cases, 7.4%), sepsis (2 cases, 7.4%), anxiety (2 cases, 7.4%) and conversion disorder (2 cases, 7.4%).
Conclusion: Stroke mimics can present with stroke-like symptoms and are often indistinguishable from true strokes. Failure to recognize an acute stroke can delay time-sensitive treatments such as tPA and mechanical thrombectomy and is associated with negative outcomes. In our study, over 30% of suspected strokes turned out to be stroke mimics. With such a high prevalence, it is important for healthcare teams to acknowledge the most common stroke mimic presentations at their own institutions. Clinicians are therefore tasked with forming a balance between rapidly diagnosing acute stroke, while also maintaining a high index of suspicion for possible stroke mimics. Further research efforts are needed to define criteria that can be utilized in the acute setting for rapid diagnosis of stroke mimics.
Academic/Professional Position
Medical Student
Mentor/PI Department
Internal Medicine
Recommended Citation
Haj-Yahya, Khairiya; Singleterry, Rodolfo; Damas, Dayan Ojeda; Ramos, Carlos; Garcia, Laura; and Cantu, Meghan Danielle, "Stroke Mimics: A Challenge for the Clinician" (2023). Research Symposium. 26.
https://scholarworks.utrgv.edu/somrs/2022/talks/26
Included in
Stroke Mimics: A Challenge for the Clinician
Background: Stroke is defined as an acute neurologic injury that is the result of a disruption in cerebral perfusion due to the blockage or rupture of an artery. Ischemic infarcts represent up to 87% of all strokes, and most commonly present with sudden onset, focal neurologic deficits that are consistent with a vascular etiology. Approximately 30% of patients presenting to the Emergency Department with stroke-like symptoms are unfortunately stroke mimics.
Stroke mimics such as syncope, sepsis, seizure, and migraines can present with stroke-like symptoms and are often indistinguishable from true strokes. The study conducted will serve to provide medical residents and medical students with a clearer understanding of such stroke mimics in the hospital setting.
Methods: The data collected through a retrospective chart review of 100 consecutive patients who were admitted to Valley Baptist Medical Center Harlingen with a provisional diagnosis of stroke. The information will be de-identified to protect the privacy of the patients. All eligible candidates, age 18 years and over, were considered regardless of race or gender.
Results: Our chart review included 85 patients presenting with stroke-like symptoms. Of these, 27 patients (31.8%) were found to be CVA mimics, while 58 patients (68.2%) were ischemic strokes or TIA.
Stroke mimics with the highest frequency in our study were migraines (5 cases, 18.5%), syncope/presyncope (2 cases, 7.4%), sepsis (2 cases, 7.4%), anxiety (2 cases, 7.4%) and conversion disorder (2 cases, 7.4%).
Conclusion: Stroke mimics can present with stroke-like symptoms and are often indistinguishable from true strokes. Failure to recognize an acute stroke can delay time-sensitive treatments such as tPA and mechanical thrombectomy and is associated with negative outcomes. In our study, over 30% of suspected strokes turned out to be stroke mimics. With such a high prevalence, it is important for healthcare teams to acknowledge the most common stroke mimic presentations at their own institutions. Clinicians are therefore tasked with forming a balance between rapidly diagnosing acute stroke, while also maintaining a high index of suspicion for possible stroke mimics. Further research efforts are needed to define criteria that can be utilized in the acute setting for rapid diagnosis of stroke mimics.