title: Identification of stroke mimics among clinically diagnosed acute strokes.
abstract: BACKGROUND
  Stroke is a clinically syndrome of a sudden onset of neurological deficit in a vascular cause. Stroke mimics is the non-vascular disorders with stroke-like clinical symptoms. It is important to distinguish true stroke from mimics since treatment plan may differ
  
  
  OBJECTIVE
  To determine the incidence of the stroke mimics and identify their etiologies.
  
  
  METHODS
  All non-contrast head CT of the patients with clinically diagnosed stroke who immediately received imaging upon arrival at the emergency department of the university hospital were retrospectively reviewed in 12-month period between January 1 and December 31, 2008. Medical records, laboratory results, MRI, and 6-month clinical follow-up records were reviewed for final diagnosis.
  
  
  RESULTS
  Seven hundred four patients were included in this study, including 363 (51.5%) men and 341 (48.5%) women with range in age from 24 to 108 years. Amongst those, 417 (59.2%) were ischemic stroke, 80 (11.40%) were hemorrhagic stroke, 186 (26.4%) were stroke-mimics, and 21 (3%) were inconclusive. The etiologies among stroke-mimics were metabolic/intoxication (35, 18.8%), sepsis (28, 15.0%), seizure (21, 11.3%), syncope (20, 10.8%), subdural hemorrhage (14, 7.5%), vertigo (11, 6.0%), brain tumor (10, 5.30%), central nervous system infection (5, 2.7%), others (26, 14.0%), and unspecified (16, 8.6%).
  
  
  CONCLUSIONS
  Incidence rates and etiologies of the stroke mimics were similar to the western reports. However the frequency of each mimic was not.
authors.affiliation: Division of Neuroradiology, Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. lojana.tun@mahidol.ac.th
authors.forename: Lojana
authors.initials: L
authors.lastname: Tuntiyatorn
authors.forename: Pichaya
authors.initials: P
authors.lastname: Saksornchai
authors.forename: Supoch
authors.initials: S
authors.lastname: Tunlayadechanont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology; D014057:Tomography, X-Ray Computed