Related Experiment Video
Updated: May 18, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombolysis to stroke mimics in telestroke
Shadi Yaghi1, Shuja Rayaz, Nicolas Bianchi
1* Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, USA.
Journal of Telemedicine and Telecare
|October 5, 2012
Summary
Telestroke networks effectively manage stroke mimics, conditions initially misdiagnosed as stroke. This study found similar rates of stroke mimics in telestroke and conventional stroke centers, indicating telemedicine
Area of Science:
- Neurology
- Telemedicine
- Emergency Medicine
Background:
- Stroke mimics are frequently misdiagnosed conditions initially presenting as stroke.
- Accurate diagnosis is crucial for appropriate treatment and patient outcomes.
- Telestroke networks aim to extend specialized stroke care to remote areas.
Purpose of the Study:
- To compare the incidence of stroke mimics in patients treated via a telestroke network versus a conventional primary stroke center.
- To evaluate the diagnostic accuracy and treatment outcomes for stroke mimics in both settings.
Main Methods:
- Retrospective review of patients receiving intravenous t-PA (alteplase) between November 2008 and January 2012.
- Comparison between patients treated at the University of Arkansas for Medical Sciences (UAMS) stroke center and the ARSAVES statewide telestroke network.
- Analysis of patient demographics, door-to-needle times, symptom onset to treatment times, and 3-month outcomes.
Main Results:
- The percentage of stroke mimics was similar between the UAMS stroke center (4.3%) and the ARSAVES telestroke network (7.8%).
- Mean door to needle time was significantly shorter at UAMS (72 min) compared to ARSAVES (91 min).
- Overall good outcomes were similar in both groups (70% vs. 58%), as were total symptom onset to treatment times (154 min vs. 156 min).
Conclusions:
- Diagnosing stroke mimics using telemedicine is as challenging as in face-to-face encounters.
- Telestroke networks can manage stroke mimics effectively, with outcomes comparable to conventional stroke centers.
- Larger prospective studies are needed to validate these findings.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...