Misdiagnosis of stroke

Between January 1980 and November 1982, of 152 patients admitted with a presumptive diagnosis of stroke to the University College Hospital (UCH), Ibadan, Nigeria, the final diagnosis was not 'stroke' in thirteen (8.6%). The true diagnoses in the thirteen patients were: glioma in three; meningioma, brain abscess, epilepsy and subdural haematoma in two patients each; hepatic coma and syringobulbia in one patient each. Failure to obtain adequate history, carry out thorough physical examination, and recognize valuable clues pointing to a different diagnosis were responsible for the misdiagnoses. Competent clinical acumen and expertise and selective cerebral angiography (in the absence of newer imaging techniques) would have prevented the errors.