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Novel Algorithm to Help Identify Stroke Mimics.

Nadeem Israr Khan1, Shilpa Chaku1, Christina Goehl2

  • 1Department of Neurology, SIU School of Medicine, Springfield, Illinois.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|November 11, 2017
PubMed
Summary
This summary is machine-generated.

A new stroke mimic score can help identify patients with stroke-like symptoms who do not have a true stroke. A score over 5 points shows high specificity for stroke mimics, reducing unnecessary treatments.

Keywords:
Strokealgorithmmimicrapid sequence MRItissue plasminogen activator

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Diagnostic Tools

Background:

  • Stroke is a leading cause of disability in the US.
  • Misdiagnosis of stroke leads to unnecessary tissue plasminogen activator (tPA) administration and healthcare costs.
  • Identifying stroke mimics is crucial for appropriate patient management.

Purpose of the Study:

  • To develop and validate a novel stroke mimic score.
  • To identify a cutoff score with high specificity for ruling in stroke mimics.
  • To improve diagnostic accuracy in emergency room stroke evaluations.

Main Methods:

  • Retrospective review of literature on stroke mimics and risk factors.
  • Development of a 9-point stroke mimic scoring system.
  • Application of the score to patients who received tPA between 2010 and 2014.

Main Results:

  • The study included 105 patients; 25% were identified as stroke mimics.
  • Stroke mimic patients were younger and had a history of seizure, migraine, or psychiatric illness.
  • A score greater than 5 demonstrated approximately 100% specificity in identifying stroke mimics.

Conclusions:

  • The stroke mimic scoring system, combined with a neurologic exam, can effectively identify stroke mimics in the ER.
  • This tool can help reduce unnecessary tPA administration and hospital admissions.
  • Further investigations like rapid MRI may be warranted for suspected stroke mimics.