Zinkstok, Sanne M.; Engelter, Stefan T.; Gensicke, Henrik; Lyrer, Philippe A.; Ringleb, Peter A.; Artto, Ville; Putaala, Jukka; Haapaniemi, Elena; Tatlisumak, Turgut; Chen, Yaohua; Leys, Didier; Sarikaya, Hakan; Michel, P.; Odier, Céline; Berrouschot, Jörg; Arnold, Marcel; Heldner, Mirjam Rachel; Zini, Andrea; Fioravanti, Valentina; Padjen, Visnja; ... (2013). Safety of thrombolysis in stroke mimics: results from a multicenter cohort study. Stroke, 44(4), pp. 1080-1084. Lippincott Williams & Wilkins 10.1161/STROKEAHA.111.000126
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BACKGROUND AND PURPOSE
Intravenous thrombolysis for acute ischemic stroke is beneficial within 4.5 hours of symptom onset, but the effect rapidly decreases over time, necessitating quick diagnostic in-hospital work-up. Initial time strain occasionally results in treatment of patients with an alternate diagnosis (stroke mimics). We investigated whether intravenous thrombolysis is safe in these patients.
METHODS
In this multicenter observational cohort study containing 5581 consecutive patients treated with intravenous thrombolysis, we determined the frequency and the clinical characteristics of stroke mimics. For safety, we compared the symptomatic intracranial hemorrhage (European Cooperative Acute Stroke Study II [ECASS-II] definition) rate of stroke mimics with ischemic strokes.
RESULTS
One hundred stroke mimics were identified, resulting in a frequency of 1.8% (95% confidence interval, 1.5-2.2). Patients with a stroke mimic were younger, more often female, and had fewer risk factors except smoking and previous stroke or transient ischemic attack. The symptomatic intracranial hemorrhage rate in stroke mimics was 1.0% (95% confidence interval, 0.0-5.0) compared with 7.9% (95% confidence interval, 7.2-8.7) in ischemic strokes.
CONCLUSIONS
In experienced stroke centers, among patients treated with intravenous thrombolysis, only a few had a final diagnosis other than stroke. The complication rate in these stroke mimics was low.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Arnold, Marcel, Heldner, Mirjam Rachel |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0039-2499 |
Publisher: |
Lippincott Williams & Wilkins |
Language: |
English |
Submitter: |
Valentina Rossetti |
Date Deposited: |
16 Jun 2014 14:45 |
Last Modified: |
05 Dec 2022 14:35 |
Publisher DOI: |
10.1161/STROKEAHA.111.000126 |
PubMed ID: |
23444310 |
BORIS DOI: |
10.7892/boris.53524 |
URI: |
https://boris.unibe.ch/id/eprint/53524 |
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