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Related Concept Videos

Stroke: Introduction and Types01:29

Stroke: Introduction and Types

A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology01:15

Ischemic 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...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic 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...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic 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...
Transient Ischemic Attack l: Introduction01:26

Transient 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...

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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
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Clinical Differences Between Stroke and Stroke Mimics in Code Stroke Patients.

Taekwon Kim1, Han-Yeong Jeong2, Gil Joon Suh3

  • 1Department of Emergency Medicine, Keimyung University School of Medicine, Daegu, Korea.

Journal of Korean Medical Science
|February 22, 2022
PubMed
Summary
This summary is machine-generated.

Identifying stroke mimics is crucial for emergency physicians. This study found that increased focal neurological deficits significantly increase the likelihood of a true stroke in code stroke patients.

Keywords:
Code StrokeEmergency DepartmentStrokeStroke Mimics

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Clinical Diagnostics

Background:

  • The code stroke system aids in identifying patients eligible for reperfusion therapy.
  • Rapidly distinguishing true strokes from stroke mimics is critical for emergency physicians to activate the code stroke protocol.
  • This study focuses on identifying key clinical and neurological characteristics for differentiating stroke from stroke mimics in the emergency department.

Purpose of the Study:

  • To investigate clinical and neurological characteristics differentiating stroke mimics from true strokes.
  • To aid emergency physicians in accurate and timely diagnosis within the emergency department setting.

Main Methods:

  • A retrospective observational study was conducted on code stroke patients presenting to the emergency department.
  • Data collected included baseline characteristics and clinical/neurological features.
  • Stroke mimics were compared with confirmed stroke cases.

Main Results:

  • Out of 409 code stroke patients, 125 (31%) were identified as stroke mimics.
  • Common mimics included seizures, drug toxicity, metabolic disorders, brain tumors, and peripheral vertigo.
  • Independent predictors for stroke mimics were psychiatric disorders, dizziness, altered mental status, and seizure-like movements.
  • Predictors for stroke included smoking, elevated systolic blood pressure, atrial fibrillation, hemiparesis, and facial palsy.
  • The likelihood of stroke increased with the number of focal neurological deficits (hemiparesis, sensory changes, facial palsy, dysarthria, aphasia, visual field defects, oculomotor disorders).

Conclusions:

  • Clinical and neurological characteristics can effectively differentiate stroke mimics from true strokes.
  • An increasing number of focal neurological deficits is strongly associated with a higher likelihood of stroke.