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Updated: Apr 8, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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Published on: January 15, 2017

Do efforts to decrease door-to-needle time risk increasing stroke mimic treatment rates?

Ava L Liberman¹, Eric M Liotta¹, Fan Z Caprio¹

¹Department of Neurology (ALL, EML, FZC, IR, MBM, RAB, DB, SP) and Department of Emergency Medicine (RK), Northwestern University-Feinberg School of Medicine, Chicago, IL.

Neurology. Clinical Practice

|July 1, 2015

Summary

This summary is machine-generated.

Rapid thrombolysis for stroke may increase treatment of stroke mimics. Faster door-to-needle times correlated with a higher proportion of stroke mimic cases, requiring careful monitoring.

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Last Updated: Apr 8, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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Published on: January 15, 2017

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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Prehospital Thrombolysis: A Manual from Berlin

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Area of Science:

Neurology
Emergency Medicine
Pharmacology

Background:

Rapid thrombolysis is crucial for acute ischemic stroke treatment.
Stroke mimics, conditions mimicking stroke, can lead to unnecessary treatment.
The relationship between treatment speed and stroke mimic rates requires investigation.

Purpose of the Study:

To investigate the association between door-to-needle (DTN) times and the incidence of thrombolysis for stroke mimics.
To analyze trends in stroke mimic treatment in relation to decreasing DTN times.

Main Methods:

Retrospective analysis of consecutive patients treated with IV tissue plasminogen activator for suspected stroke.
Data collected from a single academic center between January 1, 2010, and February 28, 2014.
Patients categorized into consecutive quartiles based on treatment order to assess changes over time.

Main Results:

A significant increase in the proportion of stroke mimic patients was observed across quartiles (6.7% to 30%; p=0.03).
Median door-to-needle times decreased significantly from 89 to 56 minutes (p<0.01).
Faster thrombolysis correlated with a higher rate of stroke mimic treatment.

Conclusions:

Reducing door-to-needle times may inadvertently increase the treatment of stroke mimics.
Healthcare facilities should monitor stroke mimic rates as they implement faster thrombolysis protocols.
Further research is needed to optimize treatment protocols and minimize misdiagnosis in acute stroke care.