Thrombolytic treatment to stroke mimic patients via telestroke

Ischemic stroke mimics: A comprehensive review

“…Confusion could be detected in 11.2% (87/775) in SM and 8.9% (115/1284) in ischemic stroke patients (p = 0.09) [11,14,16,34,38,44,59,70]. No signs of stroke on physical examination could be found 33.7% (131/389) in SM and 10.5% (36/343) in ischemic stroke patients (p < 0.001) (Fig.…”

“…Cognitive impairment 25.4% (31/122) vs. 11.1% (40/359) [11,14], and history of migraine 16.5% (151/916) vs. 11.3% (215/1900) [11,14,15,28,46,68] were more common is SM patients (p < 0.001 in both cases).…”

“…Hypertension 66.8% (20074/30035) vs. 41.1% (3434/8347) [11,14,15,19,20,21,23,24,28,[30][31][32][33][34]37,38,[40][41][42]47,48,50,52,23,[55][56][57][58][59]61,64,65,67,68,70,71], dyslipidaemia 38% (9891/26005) vs. 23.6% (1585/6717) [14,15,19,20,23,28,[32][33][34]37,40,41,48,50,52,53,…”

When migraine mimics stroke: A systematic review

“…In front of a young patient with an acute focal neurological deficit (as an MA sufferer generally is), not to perform a potentially life- or disability-saving treatment is not an easy choice at all. Door-to-needle time or stroke severity does not necessarily help in distinguishing SM from AIS (34,48), even if NIHSS scores tend to be lower in SM (49) and a clinical onset with global aphasia without hemiparesis should raise the suspicion of an SM (30,39,40). Migrainous patients show a tendency to arrive quickly at the hospital, often within 1 hour of clinical onset (59).…”

“…More recently, Quenardelle and colleagues found 521 SM out of the 1361 patients prospectively enrolled in their stroke care pathway: The authors reported 90 cases of MA, two cluster headaches and five other defined headache types, together accounting for 18.6% of detected SM (47). The rate of SM seems comparable between patients who are evaluated via telestroke (where neurologists are connected to hospitals in areas without on-site neurological expertise) and those evaluated in an SU (48). SM cover about 10% of the English case series, reported by Sivakumaran et al, where migraine was the main final non-vascular diagnosis (28%) (49).…”