title: Thrombolytic treatment to stroke mimic patients via telestroke.
abstract: OBJECTIVE
  The safety and outcomes of intravenous thrombolysis (IVT) to stroke patients via telestroke (TS) is similar to those presenting to stroke centers. Little is known on the accuracy of TS diagnosis among those receiving IVT. We sought to compare the rate of patients receiving IVT with diagnosis of ischemic stroke as opposed to stroke mimic (SM) in our TS network to those who presented to our comprehensive stroke center (CSC).
  
  
  METHODS
  Consecutive patients receiving IVT between August 2014 and June 2015 were identified at our CSC and TS network. We compared rates of SM, post-IVT symptomatic intracerebral hemorrhage (sICH), in-hospital mortality, and discharge destination.
  
  
  RESULTS
  We evaluated 131 receiving IVT were included in the analysis. Rates of SM receiving IVT were similar (CSC 12% versus 7% TS, p=0.33). Four stroke patients experienced sICH or in-hospital mortality; neither were found among SM patients. Discharge destination was similar between stroke and SM patients (p=0.9). SM patients had higher diagnoses of migraine (p=0.05) and psychiatric illness (p<0.01).
  
  
  CONCLUSIONS
  The accuracy of diagnosing stroke in IVT-eligible patients evaluated via TS is similar to evaluations at our CSC. Continued efforts should be made to minimize exposure of SM patients to IVT in both settings.
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States. Electronic address: ganesh785@gmail.com.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Asaithambi
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Castle
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Sperl
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Ravichandran
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States.
authors.forename: Aditi
authors.initials: A
authors.lastname: Gupta
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Ho
authors.affiliation: John Nasseff Neuroscience Institute, United Hospital at Allina Health, St. Paul, MN, United States.
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Hanson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy; D017216:Telemedicine / Q000592:standards*; D015912:Thrombolytic Therapy / Q000592:standards*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Diagnosis; Mimic; Stroke; Telemedicine; Telestroke; Thrombolysis