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There were 411 patients initially diagnosed as having stroke.Of these,78 patients(19%)were eventually found to have mimics,the majority comprising postictal states,systemic infections,tumors,and toxic-metabolic disturbances.Univariate analysis showed that decreased level of consciousness and normal eye movements increased the odds of mimic,while abnormal visual fields,diastolic blood pressure greater than 90 mm Hg, atrial fibrillation on electrocardiogram,and history of angina decreased the odds of mimic.Multivariate analysis showed that decreased consciousness increased,while history of angina decreased,the odds of mimic.Sensitivity of this model for predicting mimics was only 21%while specificity was 96%.For the neurologist faced with an immediate decision as to whether to randomize a patient with probable stroke to an acute treatment protocol,these findings have some usefulness but mandate further research into conditions that mimic stroke in the emergency department. |
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abscess,intracerebral
aphasia
cerebrovascular accident
cerebrovascular accident,mimics
cerebrovascular accident,misdiagnosis
encephalopathy
hepatic encephalopathy
metabolic disorder,primary
migraine
mimics
misdiagnosis
neoplasm,metastatic to CNS
neoplasm,metastatic to CNS-differential diagnosis of
neoplasm,primary intracerebral,presenting as CVA
neoplasm,primary of CNS
neurologic disease,diagnoses of
seizure
subdural hematoma
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