Stroke Mimics and Intravenous Thrombolysis

详细信息    查看全文

• 作者：Ville Artto ; MD ; PhD^a ; ^{ville.artto@hus.fi} ; Jukka Putaala ; MD ; PhD^a ; Daniel Strbian ; MD ; PhD^a ; Atte Meretoja ; MD^a ; Katja Piironen ; MD^a ; Ron Liebkind ; MD ; PhD^a ; Heli Silvennoinen ; MD ; PhD^b ; Sari Atula ; MD ; PhD^a ; Olli Hä ; ppö ; lä ; MD ; PhD^a ; Helsinki Stroke Thrombolysis Registry Group^?/sup>
• 刊名：Annals of Emergency Medicine
• 出版年：2012
• 出版时间：January 2012
• 年：2012
• 卷：59
• 期：1
• 页码：27-32
• 全文大小：229 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Study objective

The necessity for rapid administration of intravenous thrombolysis in patients with acute ischemic stroke may lead to treatment of patients with conditions mimicking stroke. We analyze stroke patients treated with intravenous thrombolysis in our center to characterize cases classified as stroke mimics.

Methods

We identified and reviewed all cases with a diagnosis other than ischemic stroke in our large-scale single-center stroke thrombolysis registry. We compared these stroke mimics with patients with neuroimaging-negative and neuroimaging-positive ischemic stroke results.

Results

Among 985 consecutive intravenous thrombolysis-treated patients, we found 14 stroke mimics (1.4 % ; 95 % confidence interval 0.8 % to 2.4 % ), 694 (70.5 % ) patients with neuroimaging-positive ischemic stroke results, and 275 (27.9 % ) patients with neuroimaging-negative ischemic stroke results. Stroke mimics were younger than patients with neuroimaging-negative or -positive ischemic stroke results. Compared with patients with neuroimaging-positive ischemic stroke results, stroke mimics had less severe symptoms at baseline and better 3-month outcome. No differences appeared in medical history or clinical features between stroke mimics and patients with neuroimaging-negative ischemic stroke results. None of the stroke mimics developed symptomatic intracerebral hemorrhage compared with 63 (9.1 % ) among patients with neuroimaging-positive ischemic stroke results and 6 (2.2 % ) among patients with neuroimaging-negative ischemic stroke results.

Conclusion

Stroke mimics were infrequent among intravenous thrombolysis-treated stroke patients in this cohort, and their treatment did not lead to harmful complications.