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Acute Ischemic Stroke - Early Management

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1 Diagnosis Table 1. Features of Clinical Situations Mimicking Stroke Diagnosis Features Psychogenic Lack of objective cranial nerve findings, neurological findings in a nonvascular distribution, inconsistent examination Seizures History of seizures, witnessed seizure activity, postictal period Hypoglycemia History of diabetes, low serum glucose, decreased level of consciousness Migraine with aura (complicated migraine) History of similar events, preceding aura, headache Hypertensive encephalopathy Headache, delirium, significant hypertension, cortical blindness, cerebral edema, seizure Wernicke's encephalopathy History of alcohol abuse, ataxia, ophthalmoplegia, confusion CNS abscess History of drug abuse, endocarditis, medical device implant with fever CNS tumor Gradual progression of symptoms, other primary malignancy, seizure at onset Drug toxicity Lithium, phenytoin, carbamazepine

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