Natalia Ramirez Rodriguez1, Camilo Romero2, Danna Cruz1
1Universidad del Rosario, 2Fundacion CardioInfantil
Objective:
To determine the incidence and the demographic, clinical and radiological characteristics of stroke mimics in patients with rapid onset neurological deficit treated at a fourth level hospital in Bogota, Colombia during 2021-2022.
Background:
Stroke is a medical emergency that requires immediate attention to establish interventions that help improve its outcome. However, up to 30% of patients who present with focal, permanent, or transient neurological deficits have pathologies other than stroke. These conditions have been grouped under the term stroke mimics. Early identification of a stroke mimics will avoid the risks of interventions and reduce the cost of care.
Design/Methods:
We carried out an observational, descriptive, cross-sectional study that included patients that were consulted to the neurology service with suspected stroke during the period from January 2021 to May 2022 and in whom the diagnosis of stroke was finally ruled out (stroke mimics). We evaluated and analyzed the demographic, clinical and imaging variables.
Results:
Out of 793 patients with rapidly appearing neurological deficits who were consulted for suspected stroke, 188 (23.7%) were stroke mimics. Most of them were women, with an average age of 66.1 years. In 16.49% of the cases, the stroke code protocol was activated. The main deficits were language alteration (23.94%), decreased state of consciousness (21.28%) and motor deficit (19.15%). Regarding the etiology, the most frequent diagnosis was delirium 22.9%, followed by epilepsy 17.6% and migraine 12.8%. None of the patients who had stroke mimics were managed with IV thrombolysis.
Conclusions:
Delirium, migraine, and epilepsy are common stroke mimics. Age, vascular risk factors, focal symptoms or signs, and the application of neurological scales can be useful elements for rapid identification and appropriate treatment. It is necessary to develop multicenter studies in Colombia to know its prevalence and describe its predictive factors by stroke subgroups.