%0 Journal Article
%T Safety of thrombolysis in stroke mimics: an observational cohort study from an urban teaching hospital in Sweden
%A David Nathanson
%A Martin Larsson
%A Mia von Euler
%A Nikolaos Kostulas
%A Tor-Bjorn Kall
%J -
%D 2017
%R 10.1136/bmjopen-2017-016311
%X Objectives Acute stroke management has changed dramatically over the recent years, where a timely assessment is driven by the expanding treatment options of acute ischaemic stroke. This increases the risk in treating non-stroke patients (stroke mimics) with a possibly hazardous intravenous thrombolysis treatment (IVT).

Setting Patients of the thrombolysis registry of S£¿dersjukhuset AB, a secondary health centre in Stockholm, were retrospectively studied to determine complications and outcome after IVT in strokes and stroke mimics.

Participants Consecutively, 674 recruited patients from 1 January 2008 to 1 December 2013 were analysed regarding demographics and outcome at 3 months after onset of symptoms.

Results Ischaemic stroke was confirmed in 625 patients (93%), and 48 patients (7%) were stroke mimics. Patients with strokes were older than stroke mimics 72 (IQR: 64¨C81) vs 54 years (IQR 40¨C67), p<0.0001. Antihypertensive and antithrombotic treatment were more common in patients with stroke (p<0.0001£¿and p=0.006, respectively). National Institute of Health Stroke Scale did not differ at time of presentation. Excellent outcome defined as modified Rankin Scale score 0¨C1, at 3 months, was less common in stroke than in stroke mimics (50% vs 87.5%, p<0.0001). No stroke mimic had a symptomatic intracerebral haemorrhage. Age of less than 40 years may be a predictor for a patient to be a stroke mimic (OR: 8.7, 95%£¿CI: 3.2 to 24.0, p<0.0001).

Conclusions Stroke mimics receiving IVT had a more favourable outcome compared with patients with stroke, and showed no haemorrhagic complications. Age below 40 years may be a predictor for stroke mimics
%U https://bmjopen.bmj.com/content/7/10/e016311