Journal of Stroke & Cerebrovascular Diseases Volume 20, Issue 6 , Pages 523-527; Wall Street Journal Health Blog

THE vast majority of strokes will occur in people over the age of 65, however, 10-15% of the stroke victims in the United States are of age 45 and younger!   A study of 57 young stroke victims published in the Journal of Stroke & Cerebrovascular Diseases from researchers at the Wayne State University-Detroit Medical Center’s Stroke Program found that 1 in 7 were misdiagnosed and sent home without being properly treated for stroke.  Among the various misdiagnoses were:  vertigo; migraine; alcohol intoxication; seizure; and inner ear dysfunction.

Why is this so important in the case of stroke?  Medical experts agree that there is a limited window for treatment of an acute stroke, beyond which the opportunity for thrombolysis (TPA or “clot busting” medications) is lost. According to Dr. Seemant Chaturvedi, the  neurologist at Wayne State who led the study, “Although young stroke victims benefit the most from early treatment, it must be administered within four and a half hours,” and, “After 48 to 72 hours, there are no major interventions available to improve stroke outcome.”

In the study, 8 patients (14%; 4 men and 4 women; mean age, 38 years) were misdiagnosed. 7 of these 8 patients were discharged from the emergency department initially. Patients age <35 years (P = .05) and patients with posterior circulation stroke (P = .006) were more likely to be misdiagnosed.  All 8 misdiagnosed patients were initially evaluated at hospitals that were not certified primary stroke centers. Patients presenting with vertebrobasilar territory ischemia have a greater rate of misdiagnosis. Our study demonstrates the increasing need for “young stroke awareness” among emergency department personnel. 

Patients seen by a qualified neurologist in the emergency room and patients who received an MRI are less likely to be diagnosed.  But regardless of your age, you should be aware of the risk potential for a stroke.  The Centers for Disease Control and Prevention have reported a steep increase in strokes among people in their 30s and 40s.  Risk factors include:  obesity; diabetes; and, high blood pressure.  Women on birth control and people who smoke are at greater risk.

Awareness and immediate action are key. “Only 20 to 30 percent of patients get to the emergency room within three hours of symptom onset,” Dr. Chaturvedi said. “They tend to wait to see if the symptoms will go away spontaneously, and they show up in the E.R. 12 to 24 hours later.”  Stroke is distinguishable from a chronic illness by the sudden onset of symptoms  The distinguishing characteristic of stroke symptoms is their sudden onset. The sudden appearance of any of the following symptoms should prompt a trip to the hospital as quickly as possible:

  • Numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Confusion, trouble speaking or understanding speech.
  • Trouble seeing in one or both eyes.
  • Difficulty walking, dizziness or loss of balance or coordination.
  • Sudden, severe headache with no known cause.

Unlike symptoms associated with a heart attack, most strokes are completely painless.  Further, even if these symptoms go away, if you are at risk then you should get evaluated.  Insist on a nuerologist and insist on an MRI.  You need to be your own health care advocate in the Emergency Room. 

The Lewis Law Firm represents patients who have been misdiagnosed with stroke and cerbrovascular accidents.  If you or a loved one were misdiagnosed with symptoms consistent with a stroke and harmed as a result, contact the Lewis Law Firm for a FREE consultation and case evaluation, today.

Posted by: Gayle R. Lewis, Esquire