Stroke Mimics: Pearls and Pitfalls

Course overview

Acute ischemic stroke (AIS) is a common and significant cause of mortality and morbidity in the United States, ranking fifth among all causes of death. It affects upwards of 800,000 people per year. Prompt recognition of an AIS is crucial, as prior imaging-based work has demonstrated that the volume of irreversibly damaged brain tissue expands rapidly until reperfusion occurs. In a recent U.S. registry study, rapid recognition followed by early thrombolytic treatment was associated with improved outcomes. In this activity we will provide you with guidelines to differentiate stroke mimics from actual strokes. We will also cover atypical presentations of strokes, known as stroke chameleons, which can challenge even the most experienced clinicians and nurses. We will review the basic tenets of stroke management, with a focus on rapid exclusion of stroke mimics and detection of stroke chameleons before definitive treatment decisions are made. After completing this activity, practitioners should be able to: define stroke mimic and stroke chameleon; appraise the risk of thrombolytics in stroke mimics; differentiate stroke mimics from stroke; summarize stroke mimic etiologies; and demonstrate management of stroke mimics.