Case Analysis of Misdiagnosis in Emergency Internal Medicine

Objective: This paper attempts to determine the clinical factors associated with the diagnosis of stroke in young adults. Method: We registered and examined young patients from the hospital stroke center. Demographic data, past medical history, 3 hours diagnosis time within the time frame, and the outcomes were assessed. We compared the patients with misdiagnosis and those who were correctly diagnosed in order to identify the factors associated with acute stroke. Results: From 2005−2011, 57 patients (16−50 years) were enrolled in the registry. 8 patients (14%; 4 men and 4 women, mean age 38 years) were misdiagnosed. Of these 8 patients, seven were initially discharged from the emergency department. Patients aged less than 35 years old (p = 0.05) and posterior circulation stroke patients (p = 0.006) were more likely to be misdiagnosed. Conclusion: First aid department needs to popularize the awareness of stroke among young adults. Misdiagnosis may cause the patient to lose the best chance of thrombolysis.

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Return to work after ischemic stroke in young adults

Neurology ◽

10.1212/wnl.0000000000006510 ◽

2018 ◽

Vol 91 (20) ◽

pp. e1909-e1917 ◽

Cited By ~ 10

Author(s):

Karoliina Aarnio ◽

Jorge Rodríguez-Pardo ◽

Bob Siegerink ◽

Juliane Hardt ◽

Jenna Broman ◽

...

Keyword(s):

Young Adults ◽

Ischemic Stroke ◽

Scale Score ◽

Young Patients ◽

Large Artery ◽

Stroke Registry ◽

Factors Associated ◽

Stroke In Young Adults ◽

Risk Sources ◽

Returning To Work

ObjectiveWe aimed to investigate the proportion of young patients not returning to work (NRTW) at 1 year after ischemic stroke (IS) and during follow-up, and clinical factors associated with NRTW.MethodsPatients from the Helsinki Young Stroke Registry with an IS occurring in the years 1994–2007, who were at paid employment within 1 year before IS, and with NIH Stroke Scale score ≤15 points at hospital discharge, were included. Data on periods of payment came from the Finnish Centre for Pensions, and death data from Statistics Finland. Multivariate logistic regression analyses assessed factors associated with NRTW 1 year after IS, and lasagna plots visualized the proportion of patients returning to work over time.ResultsWe included a total of 769 patients, of whom 289 (37.6%) were not working at 1 year, 323 (42.0%) at 2 years, and 361 (46.9%) at 5 years from IS. When adjusted for age, sex, socioeconomic status, and NIH Stroke Scale score at admission, factors associated with NRTW at 1 year after IS were large anterior strokes, strokes caused by large artery atherosclerosis, high-risk sources of cardioembolism, and rare causes other than dissection compared with undetermined cause, moderate to severe aphasia vs no aphasia, mild and moderate to severe limb paresis vs no paresis, and moderate to severe visual field deficit vs no deficit.ConclusionsNRTW is a frequent adverse outcome after IS in young adults with mild to moderate IS. Clinical variables available during acute hospitalization may allow prediction of NRTW.

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Analysis of Risk Factors Associated with Stroke in Young Adults: A Prospective Study

Journal of Dhaka Medical College ◽

10.3329/jdmc.v18i2.6265 ◽

1970 ◽

Vol 18 (2) ◽

pp. 95-99 ◽

Cited By ~ 1

Author(s):

MZ Hossain ◽

SU Ahmed ◽

MH Sarder ◽

R Dasgupta ◽

A Das ◽

...

Keyword(s):

Risk Factors ◽

Young Adults ◽

Heart Disease ◽

Ischemic Stroke ◽

Cerebral Infarction ◽

Young Patients ◽

Premature Atherosclerosis ◽

Stroke In Young Adults ◽

Common Risk Factors ◽

Stroke In Young

Objective: Stroke in young patients is not common. The purpose of this study was to find out the risk factors of stroke in young adults in Bangladesh and to compare with different other studies. Methods: 85 young adult cases of stroke patients with the age ranging from 14 to 45 years, admitted in different medical units of Dhaka Medical College Hospital from January 2008 to July 2009, were studied. The risk factors for stroke and the distribution of stroke types were analyzed. Results: The specific age group (14-45 years old) included 6% of patients of all ages admitted for stroke. Among 85 patients, cerebral infarction was diagnosed in 52 patients (61%). Intracerebral hemorrhage (without trauma) was diagnosed in 25 patients (29.4%). Subarachnoid hemorrhage was found in 7 young patients (8.24%). The most common risk factors for ischemic stroke were hypertension (57.68%), hypercholesterolemia (38.46%), diabetes (34.61%), smoking (32.69%), premature atherosclerosis (11.54%). Regarding aetiology of cerebral infarction, the majority due to cardiogenic emboli (75%). The use of oral contraceptives, pregnancy, SLE, migraine and moya moya disease were infrequent causes of cerebral infarction. In ischemic stroke, the ratio of cardiogenic emboli & other factors were 3:1. The most common risk factors for hemorrhagic stroke were hypertension (63.63%), hypercholesterolemia (39.39%), diabetes (36.54%) & smoking (33.33%). Conclusion: Hypertension, Diabetes, tobacco smoking, premature atherosclerosis & rheumatic valvular heart disease are growing problems in the developing countries. According to our finding, identification & treatment of hypertension, dyslipidaemia, diabetes & rheumatic valvular heart disease & cessation of smoking are proper measures to prevent morbidity & mortality. Key words: Risk factors; stroke; young adult. DOI: 10.3329/jdmc.v18i2.6265 J Dhaka Med Coll. 2009; 18(2) : 95-99

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Stroke in young adults – a challenge for etiology, treatment and rehabilitation

Balneo Research Journal ◽

10.12680/balneo.2020.373 ◽

2020 ◽

pp. 425-429

Author(s):

Corina ROMAN-FILIP ◽

Maria-Gabriela CATANĂ

Keyword(s):

Young Adults ◽

Young Patients ◽

Pharmacological Therapy ◽

Differential Diagnostics ◽

Artery Dissection ◽

Language Therapy ◽

Stroke In Young Adults ◽

Constraint Induced Movement Therapy ◽

Therapy Strategies ◽

Stroke In Young

Strokes occur rarely in individuals under the age of 45 and are even more uncommon under the age of 30, the etiology of this pathology in young adults being generally related to unknown or unusual causes. We present the cases of three young adults that suffered strokes with three different unusual etiologies. The three men were 30, 36 and 43 years old, with no pathological antecedents, with neurological symptoms characteristic for stroke. Because the differential diagnostics are sometimes tricky, in all three cases imagery was very helpful. It is necessary to emphasize that in these cases one of the most important things to know is the etiology. It is very important to treat the effect too; this is the reason why we never miss an opportunity to use alteplase when all conditions are met. Common rehabilitation regimes for young adults, who have suffered a stroke, include a combination of physiotherapy, occupational therapy, speech-language therapy, and pharmacological therapy. Strategies to improve motor recovery in young patients include constraint-induced movement therapy, robot-aided rehabilitation, virtual reality training, functional electrical stimulation, increased exercise intensity, and acupuncture. Keywords: stroke, young patients, etiology, thrombophilia, drugs abuse, artery dissection, rehabilitation,

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Factors Associated With Misdiagnosis of Acute Stroke in Young Adults

Journal of Stroke and Cerebrovascular Diseases ◽

10.1016/j.jstrokecerebrovasdis.2010.03.005 ◽

2011 ◽

Vol 20 (6) ◽

pp. 523-527 ◽

Cited By ~ 56

Author(s):

Abraham Kuruvilla ◽

Pratik Bhattacharya ◽

Kumar Rajamani ◽

Seemant Chaturvedi

Keyword(s):

Young Adults ◽

Acute Stroke ◽

Factors Associated ◽

Stroke In Young Adults ◽

Stroke In Young

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A Rare Cause of Stroke in Young Adults: Occlusion of the Middle Cerebral Artery by a Meningioma Postpartum

Case Reports in Neurological Medicine ◽

10.1155/2013/652538 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Stéphane Mathis ◽

Benoît Bataille ◽

Samy Boucebci ◽

Marion Jeantet ◽

Jonathan Ciron ◽

...

Keyword(s):

Young Adults ◽

Progesterone Receptor ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Young Patients ◽

Acute Presentation ◽

Stroke In Young Adults ◽

Progesterone Receptor Positivity ◽

Neurological Event ◽

Stroke In Young

Meningioma is the most common nonglial intracranial primary tumor. It is a slowly growing tumor and presents clinically by causing seizures along with neurological or neuropsychological deficit. However, acute presentation of meningioma is possible. We are reporting a case of cerebral infarction due to a sphenoid wing meningothelial meningioma (with progesterone receptor positivity) leading to an occlusion of the middle cerebral artery (MCA) in a 30-year-old right-handed woman (1 month after childbirth). After surgery, no new neurological event occurred, and she recovered most of her neurological functions. Strokes due to meningioma are a highly rare clinical occurrence but should be given serious consideration, particularly in young patients.

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