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- W2044972512 abstract "# {#article-title-2} To the Editor: We congratulate Chernyshev et al.1 on their study concerning tissue plasminogen activator (tPA) safety in patients with stroke mimics (SM). In addition to its undeniable value, some methodologic issues are controversial.It is unclear how patients were allocated in neuroimaging-negative cerebral ischemia (NNCI) and SM subgroups. The NNCI group may include TIAs and patients in whom thrombolysis succeeded. The SM group may include patients who did not have a true stroke. This determination often requires advanced parenchymal and vascular examinations immediately after admission.Chernyshev et al. reported that CT scan was the only tool for tissue evaluation before tPA, yet early vascular studies were not mentioned. If the presence of an alternative diagnosis to stroke was the only difference between SM and NNCI definitions, the underrecognition of this alternative diagnosis could misclassify SM patients into the NNCI category.Misclassification of NNCI patients into the SM subgroup could also occur. Some strokes present with seizures, headache, confusional states, or other clinical pictures that resemble stroke-mimicking conditions. In these patients, a normal CT scan at baseline and early reperfusion may lead to a negative follow-up neuroimage. However, they do not have a SM.The reported SM rate of 14% is very high. We reviewed the frequency and outcome of SM among 199 …" @default.
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- W2044972512 date "2010-11-15" @default.
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- W2044972512 title "Safety of tPA in stroke mimics and neuroimaging-negative cerebral ischemia: Swift or Sure? The Acceptable Rate of Neurovascular Mimics Among IV tPA-Treated Patients" @default.
- W2044972512 doi "https://doi.org/10.1212/wnl.0b013e3181fac7da" @default.
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