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Summary

This case series highlights rare stroke mimics and chameleons to improve acute ischemic stroke (AIS) diagnosis. Accurate identification reduces misdiagnosis and ensures timely treatment with intravenous thrombolysis (IVT) and mechanical thrombectomy (MT).

Keywords:
Acute ischemic stroke (AIS)case seriesstroke chameleons (SCs)stroke mimics (SMs)

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Diagnostic Imaging

Background:

  • Acute ischemic stroke (AIS) diagnosis is critical for timely treatment with intravenous thrombolysis (IVT) and mechanical thrombectomy (MT).
  • Distinguishing true AIS from stroke mimics (SMs) and stroke chameleons (SCs) is challenging in acute settings.
  • Accurate early diagnosis is essential to avoid misdiagnosis and ensure appropriate patient management.

Observation:

  • A retrospective case series of nine rare SMs and SCs presenting with acute onset is presented.
  • Cases were categorized into three groups: epilepsy, metabolic disorders, and myelopathy.
  • Diagnoses included AIS, epilepsy, metabolic disorders, and myelopathy, with most patients improving after prompt, correct treatment.

Findings:

  • The case series provides examples of SMs and SCs that can mimic AIS symptoms.
  • Classification by subject mode aids in differentiating these conditions from true stroke.
  • Timely diagnosis and treatment based on accurate identification led to symptom improvement in most patients.

Implications:

  • Improved identification of SMs and SCs can reduce misdiagnosis and missed diagnoses of AIS in emergency departments.
  • Accurate differentiation prevents unnecessary procedures and ensures timely administration of critical AIS treatments like IVT and MT.
  • Caution is advised against excessive diagnostic pursuit, which could delay life-saving interventions for actual AIS patients.