“Under the age of 50, most stroke mimics are migraines, epilepsy, seizures, multiple sclerosis or high blood pressure that causes swelling in the brain,” he said. “Over the age of 50, most patients experiencing a stroke mimic are the result of epilepsy, metabolic derangement or a mass lesion in the brain.”
Other real stroke mimics such as mitochondrial myopathy, encephalopathy, lactic acidosis, stroke-like episodes (MELAS), Susac's syndrome, brain tumour, demyelinating diseases and herpes simplex encephalitis are also included in our detailed and practical algorithm.
Patients with brain tumours may initially present with acute focal neurologic symptoms and may mimic a stroke [39].
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.
Introduction. Brain magnetic resonance imaging (MRI) is the preferred and most sensitive modality after transient ischemic attack (TIA) or minor stroke. It should include diffusion-weighted imaging (DWI) and should be completed within 24 hours of symptom onset1,2; its use is 3-fold.
Gliomas, meningiomas and hypophyseal adenomas are among the commonest primary tumors that may mimic a stroke. Metastatic lesions of the brain may have a similar presentation.
The Difference Between Brain Tumors and Strokes
With a stroke, the symptoms happen quickly over a period of minutes or hours. With a brain tumor, the symptoms may come on so subtlely that those around the patient take little to no notice right away. “They may be willing to write it off,” said Jensen.
Do a neurological exam. This test checks how well your nervous system is working to show whether you have had a stroke. In this exam, the doctor will ask you questions, test your reflexes, and ask you to do simple actions.
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.
While doctors should always be on the lookout for the possibility of a stroke, many are not. In fact, a number of patients who suffer from strokes are misdiagnosed or their diagnoses are delayed before they can get the treatment they need.
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).
In a recent study, 1361 patients presenting within 4.5 h with sudden onset symptoms suspected of being a stroke were imaged with MRI. Mimics were diagnosed in 38% of patients admitted as acute stroke. Migraine, functional (conversion disorder), seizures and vertigo were the most common mimic diagnosis [56].
Introduction: An infarct on brain MRI is often seen as gold standard when diagnosing ischemic stroke. Although MRI has high sensitivity in detecting a lesion shortly after ischemic stroke, this rapidly declines when time progresses.
Panic attacks are often confused with heart attacks or strokes. They share many of the same symptoms: Racing heart. Chest pains or tightness.
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.
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.
A person experiencing a TIA might feel sudden weakness or numbness on one side of the body, have slurred speech, have trouble seeing or talking, and feel confused. The person may experience a combination of these symptoms at the same time.
We now know that a multitude of infections can directly cause stroke, including bacterial (syphilis and tuberculosis are classic examples), fungal (cryptococcus, aspergillus, mucormycosis), parasitic [12] (most commonly neurocysticercosis), and numerous viruses (Table 2).