Young adults with stroke symptoms are sometimes misdiagnosed in emergency rooms

Feb 18, 2009

In the Misdiagnosis of Acute Stroke in the Young During Initial Presentation in the Emergency Room study, researchers reviewed data on 57 patients, ages 16 to 50 years old, enrolled since 2001 in the Young Stroke Registry at the Comprehensive Stroke Center at Wayne State University in Detroit, Mich.

Four males and four females (14 percent), average age 34, were misdiagnosed as having vertigo, migraine, alcohol intoxication or other conditions. They were discharged from the hospital and later discovered to have suffered a stroke. Those misdiagnosed included:

• an 18-year-old man who reported numbness on his left side but was diagnosed with alcohol intoxication;
• a 37-year-old woman who arrived with difficulty speaking and was diagnosed with a seizure;
• a 48-year-old woman with sudden blurred vision, an off-balance walk, lack of muscle coordination, difficulty speaking and weakness in her left hand, who was told she had an inner ear disorder.

"Accurate diagnosis of stroke on initial presentation in young adults can reduce the number of patients who have continued paralysis and continued speech problems," said Seemant Chaturvedi, M.D., senior author of the study and a professor of neurology and director of the stroke program at Wayne State.

"We have seen several young patients who presented to emergency rooms with stroke-like symptoms within three to six hours of symptom onset, and these patients did not get proper treatment due to misdiagnosis. The first hours are really critical."

Intravenous delivery of the clot-busting drug tissue plasminogen activator (tPA) is the only U.S. government-approved treatment for acute stroke. It must be delivered within three hours of symptom onset to reduce permanent disability caused by stroke. Chaturvedi said experimental interventional stroke treatment such as intra-arterial clot busters and mechanical clot retrieval may be an option for some patients three to eight hours after symptoms.

"Part of the problem is that the emergency room staff may not be thinking stroke when the patient is under 45 years old," Chaturvedi said. "Physicians must realize that a stroke is the sudden onset of these symptoms."

Patients arriving with "seemingly trivial symptoms like vertigo and nausea" should be assessed meticulously, he said.

"Some people believe that younger people may respond better to stroke treatments, so that makes it doubly important to recognize when a stroke is happening. After 48 to 72 hours, there are no major interventions available to improve stroke outcome."

No matter the age, people must also get to the hospital quickly if these stroke symptoms occur:

• sudden numbness or weakness of the face, arm or leg, especially on one side of the body;
• sudden confusion, trouble speaking or understanding;
• sudden trouble seeing in one or both eyes;
• sudden trouble walking, dizziness, loss of balance or coordination; and/or
• sudden, severe headache with no known cause.

Stroke is the third leading cause of death and one of the top causes of disability in the United States.

"Early intervention is the most critical component of effective stroke care," said Abraham Kuruvilla, M.D., the study's lead author and a stroke fellow in the neurology department at Wayne State University. "Early intervention will reduce the burden of disability of the young patients afflicted with stroke disability and the associated high cost of medical care in this population."

Source: American Heart Association

Explore further: FTC clears Sun Pharma's $4B purchase of competitor Ranbaxy

add to favorites email to friend print save as pdf

Related Stories

New formula predicts if scientists will be stars

Sep 12, 2012

A medical school committee is weighing whether to hire a promising young neuroscientist. Will she have a brilliant future as a researcher, publish in top journals and nab abundant research funds?

Striking the right chords

Mar 30, 2011

Practice was nearly over when high school wrestler Darrin Ching collapsed and found himself pinned to the mat, a searing pain gripping his right temple. Alarmed, his coach and teammates huddled around and tried to get him ...

Recommended for you

Why aren't there any human doctors in Star Wars?

Jan 30, 2015

Though set "a long time ago in a galaxy far, far away," it isn't hard to see in the Star Wars films a vision of our own not so distant future. But Anthony Jones, a physician with a long background in health ...

Cambodia bans 'virgin surgery' adverts

Jan 29, 2015

The Cambodian government has ordered a hospital to stop advertising so-called virginity restoration procedures, saying it harms the "morality" of society.

What's happening with your donated specimen?

Jan 28, 2015

When donating blood, plasma, human tissue or any other bodily sample for medical research, most people might not think about how it's being used. But if you were told, would you care?

Amgen tops Street 4Q forecasts

Jan 27, 2015

Amgen Inc. cruised to a 27 percent jump in fourth-quarter profit and beat Wall Street expectations, due to higher sales of nearly all its medicines, tight cost controls and a tax benefit.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.