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Stroke Diagnosis and Treatment in the Emergency Department

Stroke Diagnosis and Treatment in the Emergency Department Letters Divyanshu Dubey, MD and “chameleons.” According to Hand et al, 31% of the acute Sean J. Pittock, MD neurological deficits resembling strokes at admission are un- Karl N. Krecke, MD derlain by epilepsy, migraine, herpetic encephalitis, tumors, Eoin P. Flanagan, MD and several other mimics. We are even more likely to have a misdiagnosis should the patient be young and the neurologi- Author Affiliations: Department of Neurology, Mayo Clinic, Rochester, cal deficit mild. Indeed, Goyal et al reported that the pa- Minnesota (Dubey, Pittock, Flanagan); Department of Laboratory Medicine and tients with mimics had a significantly lower National Insti- Pathology, Mayo Clinic, Rochester, Minnesota (Pittock); Department of tutes of Health Stroke Scale score, mean age, and vascular risk Radiology, Mayo Clinic, Rochester, Minnesota (Krecke). factor burden than did the stroke group. Hence, the higher the Corresponding Author: Eoin P. Flanagan, MD, Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (flanagan.eoin@mayo.edu). complexity of the clinical picture, the stronger is the need for Published Online: January 9, 2017. doi:10.1001/jamaneurol.2016.5441 the neurologist’s expertise. Moreover, additional neurologi- cal investigations, like electroencephalography, may be needed Author Contributions: Dr Flanagan had full access to all the data in the study http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Neurology American Medical Association

Stroke Diagnosis and Treatment in the Emergency Department

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References (5)

Publisher
American Medical Association
Copyright
Copyright 2017 American Medical Association. All Rights Reserved.
ISSN
2168-6149
eISSN
2168-6157
DOI
10.1001/jamaneurol.2016.5561
pmid
28114682
Publisher site
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Abstract

Letters Divyanshu Dubey, MD and “chameleons.” According to Hand et al, 31% of the acute Sean J. Pittock, MD neurological deficits resembling strokes at admission are un- Karl N. Krecke, MD derlain by epilepsy, migraine, herpetic encephalitis, tumors, Eoin P. Flanagan, MD and several other mimics. We are even more likely to have a misdiagnosis should the patient be young and the neurologi- Author Affiliations: Department of Neurology, Mayo Clinic, Rochester, cal deficit mild. Indeed, Goyal et al reported that the pa- Minnesota (Dubey, Pittock, Flanagan); Department of Laboratory Medicine and tients with mimics had a significantly lower National Insti- Pathology, Mayo Clinic, Rochester, Minnesota (Pittock); Department of tutes of Health Stroke Scale score, mean age, and vascular risk Radiology, Mayo Clinic, Rochester, Minnesota (Krecke). factor burden than did the stroke group. Hence, the higher the Corresponding Author: Eoin P. Flanagan, MD, Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (flanagan.eoin@mayo.edu). complexity of the clinical picture, the stronger is the need for Published Online: January 9, 2017. doi:10.1001/jamaneurol.2016.5441 the neurologist’s expertise. Moreover, additional neurologi- cal investigations, like electroencephalography, may be needed Author Contributions: Dr Flanagan had full access to all the data in the study

Journal

JAMA Neurology – American Medical Association

Published: Mar 23, 2017

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