Several key elements may help differentiate the stroke mimic from an actual stroke; these include the nature of the presenting complaint, certain epidemiological factors, timing of onset, the presence of signs or symptoms from the anterior vs. posterior cerebral circulation, and the choice of imaging modality.
MRI scans provide accuracy and sensitivity in identifying stroke mimics (Lam et al 2005, Guerrero et al 2012), and the incidence of misdiagnosis of a stroke can drop to 2% with the use of MRI scans (Nau et al 2010). The CT scan is the gold standard for diagnosis of acute strokes.
One of the most common stroke mimics is a seizure, which researchers believe account for as many as 20% of all stroke mimics. Other common stroke mimics include migraines, syncope, sepsis, brain tumor and metabolic derangement (low sodium or low blood sugar).
Some of the most common stroke mimics are seizures, migraine, fainting and serious infections.
A transient ischemic attack (TIA) is a temporary period of symptoms similar to those of a stroke. A TIA usually lasts only a few minutes and doesn't cause permanent damage. Often called a ministroke, a TIA may be a warning.
Call 9-1-1 immediately if any of these signs of stroke appear: Numbness or weakness in the face, arm, or leg; Confusion or trouble speaking or understanding speech; Trouble seeing in one or both eyes; Trouble walking, dizziness, or problems with balance; severe headache with no known cause.
Yes, you can have a stroke and not know it. A stroke's effects can be undetectable if the stroke is small or if the tissue damaged does not serve a critical function. Evidence of the stroke would show on a CT scan or an MRI of the brain, but it might not produce symptoms.
Unlike a CT scan, which takes several hours to reveal any blockages of blood flow, an MRI can uncover any brain damage within an hour of the onset of the stroke symptoms.
Panic attacks are often confused with heart attacks or strokes. They share many of the same symptoms: Racing heart. Chest pains or tightness.
In addition to the classic stroke symptoms associated with the FAST acronym, around 7-65% of people undergoing a stroke will experience some form of a headache. People describe a stroke-related headache as a very severe headache that comes on within seconds or minutes.
If a stroke is suspected, a CT scan is usually able to show whether you have had an ischaemic stroke or a haemorrhagic stroke. It's generally quicker than an MRI scan and can mean you're able to receive appropriate treatment sooner.
Some people have strokes without realizing it. They're called silent strokes, and they either have no easy-to-recognize symptoms, or you don't remember them. But they do cause permanent damage in your brain. If you've had more than one silent stroke, you may have thinking and memory problems.
Magnetic resonance imaging (MRI).
An MRI can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiography or magnetic resonance venography).
Facial weakness, arm weakness and difficulty with speech are the most common symptoms or signs of stroke, but they are not the only signs. The following signs of stroke may occur alone or in combination: Weakness or numbness or paralysis of the face, arm or leg on either or both sides of the body.
Computerized tomography (CT) scan – CT scans use a series of X-rays to create a detailed image of your brain. A CT scan can show a hemorrhage, tumor, stroke and other conditions. There are different types of CT scans that your doctor may use depending on your situation.
The only way to tell the difference between a ministroke and a stroke is by having a doctor look at an image of your brain with either a CT scan or an MRI scan. If you've had an ischemic stroke, it's likely that it won't show up on a CT scan of your brain for 24 to 48 hours. An MRI scan usually shows a stroke sooner.
Weakness or numbness of the face, arm or leg, usually on one side of the body. Trouble speaking or understanding. Problems with vision, such as dimness or loss of vision in one or both eyes. Dizziness or problems with balance or coordination.
During a silent stroke, an interruption in blood flow destroys areas of cells in a part of the brain that is "silent," meaning that it doesn't control any vital functions. Although the damage will show up on an MRI or CT scan, it's too small to produce any obvious symptoms.
The longer a stroke goes untreated, the more damage can be done — possibly permanently — to the brain. “If you suspect you or someone you're with is having a stroke, don't hesitate to call 911,” Dr. Humbert says. “It could save a life.”
An MRI scan is most often used. This type of scan uses a strong magnetic field and radio waves to create an image of your brain.
The first stage is flaccidity , and occurs immediately post-stroke. Muscles will be weak, limp, or even "floppy." Because a stroke often affects one side more than the other, this flaccidity may be limited to just one side.
This meta-analysis of 11 816 strokes provides strong evidence that the onset of stroke symptoms has a circadian variation, with a higher risk in the early morning hours (6 am to noon), and lower risk during the nighttime period (midnight to 6 am).