[Stroke and transient ischemic attack-mimicking conditions: a prospective analysis of risk factors and clinical profiles at a general hospital].
BACKGROUND
Nonvascular structural entities can simulate stroke and transient ischemic attacks (TIA) in a variable percentage, but this issue has not been properly addressed in our environment. Their differentiation is important, since the management of patients with a true cerebrovascular accident differs considerably from that of mimicking conditions.


OBJECTIVE
To analyze prospectively those structural disorders that mimic stroke and TIA in the department of neurology of a general hospital and to determine if there are any distinctive risk factors and/or clinical presentations that would allow for their separation from true stroke and TIA.


METHODS
All patients admitted to our Department of Neurology with stroke or TIA were evaluated prospectively for a 4-year period. Those in whom a mimicking condition was disclosed were the subjects of this study. Their clinical features and vascular risk factors were compared with a sample of randomly selected patients with true stroke or TIA admitted during the same period.


RESULTS
A total of 28 patients comprised the stroke-TIA mimicking group, 21 of them had a stroke-like syndrome and 7 a TIA-like syndrome. The mimicking group represented a 1.9% (2% of strokes and 1.6% of TIA) of all the patients with true cerebrovascular disorders admitted during the same period. Cancer, either primary or metastatic, was the single most frequent mimicking condition, accounting for two-thirds of the cases. Risk factors for stroke and TIA were significantly more frequent in the true stroke-TIA group without differences in age or sex, while the opposite is true in terms of prior or concurrent cancer. No single clinical profile allowed for a distinction between the two groups, although vertebrobasilar dysfunction suggested true ischemia, and vomiting, isolated dysarthria and dysarthria-clumsy hand occurred only in the true stroke-TIA group.


CONCLUSIONS
Nonvascular conditions can cause signs and symptoms indistinguishable from true stroke and TIA, representing about 2% of the patients admitted to a department of neurology with these diagnoses. Although there are some differences in clinical presentation and risk factors between both groups, neuroimaging studies will be required in the individual patient to rule out mimicking conditions.
García-Moncó
J C
JC
Servicio de Neurología, Hospital de Galdácano, Vizcaya, Spain.
Marrodán
A
A
Foncea Beti
N
N
Gómez Beldarrain
M
M
D001932:Brain Neoplasms / Q000503:physiopathology; D003937:Diagnosis, Differential; D006408:Hematoma, Subdural / Q000503:physiopathology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology*