Stroke Chameleons and Stroke Mimics in the Emergency Department.

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  • Additional Information
    • Source:
      Publisher: Current Science Inc Country of Publication: United States NLM ID: 100931790 Publication Model: Print Cited Medium: Internet ISSN: 1534-6293 (Electronic) Linking ISSN: 15284042 NLM ISO Abbreviation: Curr Neurol Neurosci Rep Subsets: MEDLINE
    • Publication Information:
      Original Publication: Philadelphia, PA : Current Science Inc., c2001-
    • Subject Terms:
    • Abstract:
      Purpose of Review: We discuss the frequency of stroke misdiagnosis in the emergency department (ED), identify common diagnostic pitfalls, describe strategies to reduce diagnostic error, and detail ongoing research.
      Recent Findings: The National Academy of Medicine has re-defined and highlighted the importance of diagnostic errors for patient safety. Recent rates of stroke under-diagnosis (false-negative cases, "stroke chameleons") range from 2-26% and 30-43% for stroke over-diagnosis (false-positive cases, "stroke mimics"). Failure to diagnosis stroke can preclude time-sensitive treatments and has been associated with poor outcomes. Strategies have been developed to improve detection of posterior circulation stroke syndromes, but ongoing work is needed to reduce under-diagnosis in other atypical stroke presentations. The published rates of harm associated with stroke over-diagnosis, particularly thrombolysis of stroke mimics, remain low. Additional strategies to improve the accuracy of stroke diagnosis should focus on rapid clinical reasoning in the time-sensitive setting of acute ischemic stroke and identifying imperfections in the healthcare system which may contribute to diagnostic error.
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    • Contributed Indexing:
      Keywords: Diagnostic error; Misdiagnosis; Stroke assessment
    • Publication Date:
      Date Created: 20170224 Date Completed: 20170814 Latest Revision: 20220331
    • Publication Date:
      20240829
    • Accession Number:
      10.1007/s11910-017-0727-0
    • Accession Number:
      28229398