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ASA: Younger Stroke Patients May Be Misdiagnosed

Researchers urge increased 'young stroke awareness' among emergency department personnel

THURSDAY, Feb. 19 (HealthDay News) -- When younger patients present to the emergency department with stroke-like symptoms, they are often misdiagnosed and sent home. In addition, pharmacists often give inappropriate advice to patients who call to complain about stroke-like symptoms, according to research presented at the American Stroke Association's International Stroke Conference held Feb. 17 to 20 in San Diego.

In one study, Abraham Kuruvilla, M.D., of Wayne State University in Detroit, and colleagues reviewed data on 57 patients aged 16 to 50 who were enrolled in their Young Stroke Registry. They found that seven patients (median age 34) who presented at the emergency department were misdiagnosed with conditions such as alcohol intoxication, inner ear disorder, vertigo or migraine, and discharged home. In six of the seven patients, the final stroke diagnosis was vertebrobasilar territory ischemic stroke.

In a second study, A.J. Monseau and colleagues from West Virginia University in Morgantown, W.V., presented 65 pharmacists, five pharmacy technicians/assistants and one pharmacy student, with a hypothetical stroke scenario. Only 14 pharmacy personnel (20 percent) correctly advised calling 911 for an ambulance while 69 percent of them recommended taking the hypothetical patient to the emergency department in a private vehicle.

"Young patients presenting with stroke-like symptoms in the distribution of the vertebrobasilar territory have a higher chance of being misdiagnosed during the initial visit to the emergency room," Kuruvilla and colleagues conclude. "Such patients presenting with seemingly trivial symptoms like vertigo and nausea should be assessed very meticulously by looking for associated central nervous system symptoms/signs. Our study indicates that there is an increasing need for 'young stroke awareness' among emergency room personnel."

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