['Stroke chameleons'].

Area of Science:

• Neurology
• Emergency Medicine
• Radiology

Background:

• Timely diagnosis of acute stroke is essential for initiating effective treatments like reperfusion therapy.
• Atypical stroke symptoms can mimic non-vascular events, complicating clinical diagnosis and delaying treatment.
• Vascular risk factors warrant suspicion for stroke even with non-specific neurological symptoms.

Purpose of the Study:

• To describe variants of strokes presenting with atypical symptoms (strokes-chameleons).
• To emphasize the critical role of thorough clinical examination in diagnosing stroke.
• To provide differential diagnostic criteria and discuss neuroimaging limitations in stroke detection.

Main Methods:

• Review of clinical presentations of atypical strokes.
• Analysis of differential diagnostic challenges in acute neurological events.
• Evaluation of the utility and limitations of neuroimaging (CT, MRI) in stroke diagnosis.

Main Results:

• Identified key atypical stroke presentations that can mislead diagnosis.
• Demonstrated that negative CT or MRI findings do not rule out stroke (ischemic or hemorrhagic).
• Highlighted the importance of clinical suspicion and examination in diagnosing challenging stroke cases.

Conclusions:

• Clinical evaluation remains paramount, especially when stroke symptoms are atypical.
• Neuroimaging should be interpreted cautiously, as negative results do not exclude stroke.
• Recognizing "strokes-chameleons" improves diagnostic accuracy and patient outcomes.