Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes

Emma JC Wallace, Ava L Liberman Montefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USACorrespondence: Ava L LibermanMontefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, 3316 Rochambeau Avenue, 4th Floor, Bronx, NY,...

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Autores principales:	Wallace EJC, Liberman AL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diagnostic error stroke chameleons cerebrovascular disease stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/edc5200c8e0541ba99f07bf96e71c156
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spelling	oai:doaj.org-article:edc5200c8e0541ba99f07bf96e71c1562021-12-02T17:04:44ZDiagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes1178-2021https://doaj.org/article/edc5200c8e0541ba99f07bf96e71c1562021-05-01T00:00:00Zhttps://www.dovepress.com/diagnostic-challenges-in-outpatient-stroke-stroke-chameleons-and-atypi-peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Emma JC Wallace, Ava L Liberman Montefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USACorrespondence: Ava L LibermanMontefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, 3316 Rochambeau Avenue, 4th Floor, Bronx, NY, 10467, USAEmail avliberm@montefiore.orgAbstract: Failure to diagnose transient ischemic attack (TIA) or stroke in a timely fashion is associated with significant patient morbidity and mortality. In the outpatient or clinic setting, we suspect that patients with minor, transient, and atypical manifestations of cerebrovascular disease are most prone to missed or delayed diagnosis. We therefore detail common stroke chameleon symptoms as well as atypical stroke presentations, broadly review new developments in the study of diagnostic error in the outpatient setting, suggest practical clinical strategies for diagnostic error reduction, and emphasize the need for rapid consultation of stroke specialists when appropriate. We also address the role of psychiatric disease and vascular risk factors in the diagnostic evaluation and treatment of suspected stroke/TIA patients. We advocate incorporating diagnostic time-outs into clinical practice to assure that the diagnosis of TIA or stroke is considered in all relevant patient encounters after a detailed history and examination are conducted in the outpatient setting.Keywords: diagnostic error, stroke chameleons, cerebrovascular disease, strokeWallace EJCLiberman ALDove Medical Pressarticlediagnostic errorstroke chameleonscerebrovascular diseasestrokeNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 1469-1480 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diagnostic error stroke chameleons cerebrovascular disease stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	diagnostic error stroke chameleons cerebrovascular disease stroke Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Wallace EJC Liberman AL Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes
description	Emma JC Wallace, Ava L Liberman Montefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, Bronx, NY, USACorrespondence: Ava L LibermanMontefiore Medical Center, Albert Einstein College of Medicine, Department of Neurology, 3316 Rochambeau Avenue, 4th Floor, Bronx, NY, 10467, USAEmail avliberm@montefiore.orgAbstract: Failure to diagnose transient ischemic attack (TIA) or stroke in a timely fashion is associated with significant patient morbidity and mortality. In the outpatient or clinic setting, we suspect that patients with minor, transient, and atypical manifestations of cerebrovascular disease are most prone to missed or delayed diagnosis. We therefore detail common stroke chameleon symptoms as well as atypical stroke presentations, broadly review new developments in the study of diagnostic error in the outpatient setting, suggest practical clinical strategies for diagnostic error reduction, and emphasize the need for rapid consultation of stroke specialists when appropriate. We also address the role of psychiatric disease and vascular risk factors in the diagnostic evaluation and treatment of suspected stroke/TIA patients. We advocate incorporating diagnostic time-outs into clinical practice to assure that the diagnosis of TIA or stroke is considered in all relevant patient encounters after a detailed history and examination are conducted in the outpatient setting.Keywords: diagnostic error, stroke chameleons, cerebrovascular disease, stroke
format	article
author	Wallace EJC Liberman AL
author_facet	Wallace EJC Liberman AL
author_sort	Wallace EJC
title	Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes
title_short	Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes
title_full	Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes
title_fullStr	Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes
title_full_unstemmed	Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes
title_sort	diagnostic challenges in outpatient stroke: stroke chameleons and atypical stroke syndromes
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/edc5200c8e0541ba99f07bf96e71c156
work_keys_str_mv	AT wallaceejc diagnosticchallengesinoutpatientstrokestrokechameleonsandatypicalstrokesyndromes AT libermanal diagnosticchallengesinoutpatientstrokestrokechameleonsandatypicalstrokesyndromes
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Diagnostic Challenges in Outpatient Stroke: Stroke Chameleons and Atypical Stroke Syndromes

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