Stroke mimics in a Brazilian stroke center: a retrospective cohort in a Brazilian stroke unit

This study assessed stroke patients in a Brazilian unit to describe the prevalence, clinical presentation, etiology, and treatment outcomes of cases initially diagnosed as stroke mimics (SM). SM refers to conditions that mimic stroke but are not caused by cerebrovascular events. Misdiagnosis can lead to unnecessary and potentially harmful treatments. The study examined patients admitted between October 2012 and September 2013. Among patients with symptoms onset within four hours, 7.1% (10 patients) were classified as SM. Six of these patients received intravenous thrombolysis, a treatment for acute ischemic stroke. The main clinical presentations among SM cases were motor symptoms (90%), dysarthria, and sensory symptoms (60%). The etiology of SM cases varied, with functional disorders being the most common (60%). The findings reveal a significant percentage of patients admitted to the stroke unit were ultimately diagnosed as SM, highlighting the need for improved diagnostic strategies to differentiate between stroke and SM. The study underscores the importance of developing well-defined guidelines to assess SM risk and utilize imaging methods for distinguishing between stroke and SM. Further research is necessary to address these issues and enhance stroke diagnosis accuracy.