Young Stroke Patients Often Misdiagnosed

Stroke and Brain

Stroke is a diagnosis associated with old age. Stroke is the third leading cause of death and one of the top causes of disability in the United States.

Physicians know that strokes can occur at any age, but they sometimes make the mistake of thinking that stroke is a diagnosis of old age. Because of this, young adults who present to emergency rooms may be misdiagnosed.

This finding was presented earlier this week at the American Stroke Association's International Stroke Conference 2009 in Sand Diego, California. Researchers presented the study "In the Misdiagnosis of Acute Stroke in the Young During Initial Presentation in the Emergency Room." For the study, the researchers reviewed data on 57 patients, ages 16 to 50 years old. These 57 patients were enrolled in the Young Stroke Registry at the Comprehensive Stroke Center at Wayne State University in Detroit, Michigan since 2001.

Common misdiagnoses included vertigo, migraine, alcohol intoxication. Many were discharged from the hospital only to later be discovered to have suffered a stroke.


Examples given of 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.

It is important in the treatment of strokes that the diagnosis be made early. The first hours are really critical. It is during this time that intravenous delivery of tPA (clot-busting drug tissue plasminogen activator) needs to be given if the stroke is due to a clot and not a bleed (or hemorrhagic stroke). This drug must be given within three hours of symptom onset to reduce permanent disability caused by stroke. This is true no matter the patient's age.

Regardless of the person's age, get them 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.

Accurate diagnosis of stroke on initial presentation in young adults can reduce the number of patients who have continued paralysis and continued speech problems. Accurate diagnosis will help ensure that the patient gets the early intervention that is critical for effective stroke care. This means that patients arriving in the ER with vertigo and nausea, young or old, need to be meticulously assessed so that strokes are diagnosed early and not late.

For more information on Strokes
Stroke Association

American Heart Association News Release


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