Which conditions should be included in the differential diagnoses of ischemic stroke?

Updated: May 27, 2020
  • Author: Edward C Jauch, MD, MS, FAHA, FACEP; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Stroke mimics commonly confound the clinical diagnosis of stroke. One study reported that 19% of patients diagnosed with acute ischemic stroke by neurologists before cranial CT scanning actually had non-cerebrovascular causes for their symptoms.

The most frequent stroke mimics include the following:

  • Seizure (17%)

  • Systemic infection (17%)

  • Brain tumor (15%)

  • Toxic-metabolic disorders, such as hyponatremia and hypoglycemia (13%)

  • Positional vertigo (6%)

  • Conversion disorder

In the prehospital and Emergency Department (ED) settings, hypoglycemia is a common stroke mimic and is particularly important to consider, since it can be readily detected and corrected. [59, 60] For more information, see Hyperglycemia and Hypoglycemia in Stroke.


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