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).
Overview. 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.
Some of the most common stroke mimics are seizures, migraine, fainting and serious infections. Once the person is diagnosed, they can have treatment or support to manage their 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.
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.
Psychogenic pseudostroke (PS) is when symptoms are suggestive of a stroke, but in reality, of psychogenic origin. Most neurologists have encountered a case of such nature. However, specific information regarding its prevalence and management is scarce.
Strokes may not be seen on a CT scan for several reasons. It can sometimes take several hours for the brain to appear abnormal after the onset of stroke. The affected region may also be a part of the brain that CT scans do not image well, such as the cerebellum or the brainstem.
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.
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.
5 How- ever, earlier studies have shown that MRI may not detect acute strokes in 10-20% of patients. 4-6 Few clinical details of the false-negative cases were provided. Although several aspects of MRI techniques, computer software, and scan interpretations have been improved, false-negative MRI results may still occur.
Unfortunately, misdiagnosis of a TIA is fairly common. One expert even estimated that misdiagnoses account for up to 160,000 deaths or debilitating brain injuries annually, as a prompt medical response to a TIA is critical to the prevention of a full-blown stroke.
Panic attacks are often confused with heart attacks or strokes. They share many of the same symptoms: Racing heart. Chest pains or tightness.
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.
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.
A brain CT scan can show if there is bleeding in the brain or damage to the brain cells from a stroke. Magnetic resonance imaging (MRI) uses magnets and radio waves to create pictures of your brain. An MRI may be used instead of—or in addition to—a CT scan to diagnose a stroke.
In fact, ischemic strokes unfold over a period of 10 hours. That means that with every second you wait for treatment, the brain damage gets worse. If a stroke is untreated for the full 10 hours, the brain ages up to 36 years! With every minute you wait, the brain loses two million brain cells.
Large haemorrhages remain visible as such for 2–3 weeks. There is no “optimal” time to image stroke patients with CT and expect to show a definite infarct. Many infarcts do not become visibly hypodense until hours or even a day after the stroke, if ever.
These physicians know the symptoms and signs found in stroke patients and the detailed differential diagnosis of stroke subtypes. They are very familiar with the symptoms, signs, and diagnosis of other neurological disorders. They are knowledgeable about stroke recovery and rehabilitation.
You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not.
CT scans are excellent at detecting the bleeding in the brain that occurs in hemorrhagic stroke. However, ischemic stroke may be difficult or impossible to see in CT images, especially during the first few hours after the stroke occurs, which is the period when treatment decisions are most important.
Ghost infarct core refers to the phenomenon that CT perfusion may overestimate infarct core on admission, especially in the early time window of a stroke, by predicting lesion in areas that will not show infarct on follow-up imaging 1. This mismatch is defined as the initial infarct core - final infarct (>10 mL).