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Factors associated with migraine aura mimicking stroke in code stroke.
Adrià Macias-Gómez1,2, Antoni Suárez-Pérez1,2, Ana Rodríguez-Campello1,2
1Neurology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003, Barcelona, Spain.
Summary
Migraine with aura (MA) can mimic stroke. A model using age, sex, NIHSS, and fibrinogen effectively differentiates MA from ischemic stroke in code stroke patients.
Area of Science:
- Neurology
- Stroke research
- Diagnostic tools
Background:
- Migraine with aura (MA) frequently simulates stroke, leading to misdiagnosis and inappropriate treatments.
- Accurate differentiation between MA and ischemic stroke is crucial for patient management.
Purpose of the Study:
- To identify clinical and laboratory differences between MA and ischemic stroke patients.
- To develop a diagnostic model for distinguishing MA from ischemic stroke in emergency settings.
Main Methods:
- Retrospective analysis of "code stroke" cases between January 2005 and June 2020.
- Multivariable logistic regression to identify predictors of ischemic stroke.
- Development and validation of a predictive model using clinical and blood data.
Main Results:
- MA patients were younger, more frequently female, and had fewer vascular risk factors than ischemic stroke patients.
- Lower levels of glucose, D-dimer, and fibrinogen were observed in MA cases.
- A model incorporating age, sex, NIHSS, and fibrinogen demonstrated high discrimination (AUC=0.89) between MA and ischemic stroke.
Conclusions:
- Age, sex, NIHSS, and fibrinogen levels are valuable predictors for differentiating MA from ischemic stroke in "code stroke" scenarios.
- Further research is needed to validate these findings for clinical diagnostic rule implementation.
