Related Experiment Video
Updated: May 10, 2026

The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
The differential diagnosis of suspected stroke: a systematic review
1Department of Clinical Radiology, Western General Hospital, Edinburgh EH4 2XU, UK. lornagibson1@nhs.net
Background:
We aimed to determine the proportion of patients who had suffered a stroke and compare this to those patients with suspected stroke, and the range of differential diagnosis for suspected stroke.
Methods:
We searched for prospective studies of suspected stroke in electronic databases and our personal files. We undertook a meta-analysis of these studies, aimed at determining the proportions of patients with confirmed stroke in different settings.
Results:
We identified 29 studies involving 8,839 patients: 13 studies were from emergency departments, five from stroke units or transient ischaemic attack (TIA) clinics, three from primary care, three from ambulance services and five were unspecified. About three-quarters (74% [95% confidence interval (CI): 66 to 83%]) of patients had a diagnosis of stroke, though there was significant heterogeneity in this estimate. The five most frequent non-stroke diagnoses were seizure, syncope, sepsis, migraine and brain tumours.
Conclusion:
Patients who had not had a stroke accounted for a significant proportion of people referred to stroke services. Expertise in the differential diagnoses of stroke is needed in order to manage the patients at the point of referral.
Related Concept Videos
Stroke: Introduction and Types
Ischemic Stroke l: Introduction
Ischemic Stroke ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology
Hemorrhagic Stroke l: Introduction
Transient Ischemic Attack l: Introduction

