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Updated: May 28, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Stroke mimics and intravenous thrombolysis
Ville Artto1, Jukka Putaala, Daniel Strbian
1Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland. ville.artto@hus.fi
Annals of Emergency Medicine
|October 18, 2011
Summary
Stroke mimics are rare in patients receiving intravenous thrombolysis for acute ischemic stroke. Treating these mimics did not result in harmful complications, suggesting safety in rapid stroke treatment protocols.
Area of Science:
- Neurology
- Emergency Medicine
- Clinical Research
Background:
- Rapid intravenous thrombolysis is crucial for acute ischemic stroke.
- This urgency may lead to treating conditions that mimic stroke.
- Characterizing stroke mimics is essential for optimizing treatment protocols.
Purpose of the Study:
- To analyze stroke patients treated with intravenous thrombolysis.
- To characterize cases classified as stroke mimics.
- To evaluate the safety and outcomes of treating stroke mimics.
Main Methods:
- Reviewed cases with non-ischemic stroke diagnoses in a thrombolysis registry.
- Compared stroke mimics with neuroimaging-negative and -positive ischemic stroke patients.
- Analyzed patient demographics, clinical features, and outcomes.
Main Results:
- Stroke mimics represented 1.4% of thrombolysis-treated patients.
- Mimics were younger, with less severe symptoms and better outcomes than neuroimaging-positive stroke patients.
- No symptomatic intracerebral hemorrhage occurred in mimics versus 9.1% in neuroimaging-positive and 2.2% in neuroimaging-negative stroke patients.
Conclusions:
- Stroke mimics are infrequent in this intravenous thrombolysis cohort.
- Treatment of stroke mimics with thrombolysis was not associated with harmful complications.
- Findings support the safety of rapid thrombolysis protocols even with potential mimics.
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