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Demin D.A.

Federal Center for Cardiovascular Surgery, Astrakhan, Russia

Belopasov V.V.

Astrakhan State Medical University, Astrakhan, Russia

Asfandiiarova E.V.

Alexandro-Mariinskay Regional Clinical Hospital, Astrakhan, Russia

Zhuravleva E.N.

Alexandro-Mariinskay Regional Clinical Hospital, Astrakhan, Russia

Mintulaev I.S.

Alexandro-Mariinskay Regional Clinical Hospital, Astrakhan, Russia

Nikolaeva E.V.

Federal Center for Cardiovascular Surgery, Astrakhan, Russia

«Stroke chameleons»

Authors:

Demin D.A., Belopasov V.V., Asfandiiarova E.V., Zhuravleva E.N., Mintulaev I.S., Nikolaeva E.V.

More about the authors

Read: 3074 times


To cite this article:

Demin DA, Belopasov VV, Asfandiiarova EV, Zhuravleva EN, Mintulaev IS, Nikolaeva EV. «Stroke chameleons». S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(4):72‑80. (In Russ.)
https://doi.org/10.17116/jnevro201911904172

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References:

  1. WHO. Cardiovascular disease. The atlas of heart disease and stroke. http://www.who.int/cardiovascular_diseases/resources/atlas/en/ (accessed Dec 4, 2010).
  2. Huff JS. Stroke mimics and chameleons. Emerg Med Clin North Am. 2002;20:583-595. https://doi.org/10.1016/s0733-8627(02)00012-3
  3. Warlow CP, Dennis MS, van Gijn J, Hankey GJ, Sandercocl PAG, Bamford JM, Wardlaw JM. Stroke. A practical guide to management. Pod red. Skoromtsa A.A., Sorokoumova V.A. Per. s angl. SPb. 1998. (In Russ.)
  4. Edlow JA, Selim MH. Atypical presentations of acute cerebrovascular syndromes. Lancet Neurol. 2011;10:550-560. https://doi.org/10.1016/s1474-4422(11)70069-2
  5. Anathhanam S, Hassan A. Mimics and Chameleons in Stroke. Clin Med (Lond.). 2017;17(2):156-160. https://doi.org/10.7861/clinmedicine.17-2-156
  6. Newman-Toker DE, Pronovost PJ. Diagnostic errors — the next frontier for patient safety. J Am Med Assoc. 2009;301:1060-1062. https://doi.org/10.1001/jama.2009.249
  7. Saber Tehrani AS, Lee H, Mathews SC, Shore A, Makary MA, Pronovost PJ, Newman-Toker DE. 25-Year summary of US malpractice claims for diagnostic errors 1986—2010: an analysis from the National Practitioner Data Bank. BMJ Qual Saf. 2013;22:672-680. https://doi.org/10.1136/bmjqs-2012-001550
  8. Newman-Toker DE, Moy E, Valente E, Coffey R, Hines AL. Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample. Diagnosis (Berlin, Germany). 2014;1(2):155-166. https://doi.org/10.1515/dx-2013-0038
  9. Lever NM, Nyström KV, Schindler JL, Halliday J, Wira C 3rd, Funk M. Missed Opportunities for Recognition of Ischemic Stroke in the Emergency Department. Journal of Emergency Nursing. Elsevier BV. 2013;39(5):434-439. https://doi.org/10.1016/j.jen.2012.02.011
  10. Richoz B, Hugli O, Dami F, Carron PN, Faouzi M, Michel P. Acute stroke chameleons in a university hospital: risk factors, circumstances, and outcomes. Neurology. 2015;85:505-511. https://doi.org/10.1212/wnl.0000000000001830
  11. Rizos T, Ringleb PA, Huttner HB, Kohrmann M, Juttler E. Evolution of stroke diagnosis in the emergency room: a prospective observational study. Cerebrovasc Dis. 2009;28:448-453. https://doi.org/10.1159/000235989
  12. Dupre CM, Libman R, Dupre SI, Katz JM, Rybinnik I, Kwiatkowski T. Stroke chameleons. J Stroke Cerebrovasc Dis. 2014;23:374-378. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.07.015
  13. Dunne JW, Leedman PJ, Edis RH. Inobvious stroke: a cause of delirium and dementia. Aust N Z J Med. 1986;16:771-78. https://doi.org/10.1111/j.1445-5994.1986.tb00034.x
  14. Benbaddis S, Sila C, Cristea R. Mental status changes and stroke. J Stroke Cerebrovasc Dis. 1994;9(9):216-219. https://doi.org/10.1016/s1052-3057(10)80093-x
  15. De Melo RC, Lopes R, Alves JC. Bipolar Disorder after Stroke in an Elderly Patient. Case Reports in Psychiatry. 2014;2014:741934. https://doi.org/10.1155/2014/741934
  16. Carrera E, Bogousslavsky J. The thalamus and behavior: effects of anatomically distinct strokes. Neurology. 2006;66:1817-1823. https://doi.org/10.1212/01.wnl.0000219679.95223.4c
  17. McMurtray A, Tseng B, Diaz N, Chung J, Mehta B, Saito E. Acute psychosis associated with subcortical stroke: comparison between basal ganglia and mid-brain lesions. Case Rep Neurol Med. 2014;428425. https://doi.org/10.1155/2014/428425
  18. Crail-Melendez D, Atriano-Mendieta C, Carrillo-Meza R, Ramirez-Bermudez J. Schizophrenia-like psychosis associated with right lacunar thalamic infarct. Neurocase. 2013;19(1):22-26. https://doi.org/10.1080/13554794.2011.654211
  19. Booij HA, Hamburger HL, Jobsis GJ, Beuerle EY, Kruyt ND. Stroke mimicking conversion disorder: two young women who put our feet back on the ground. Pract Neurol. 2012;12:179-181. https://doi.org/10.1136/practneurol-2011-000152
  20. Fernandes PM, Whiteley WN, Hart SR, Al-Shahi Salman R. Strokes: mimics and chameleons. Practical Neurology. 2013;13:21-28. https://doi.org/10.1136/practneurol-2012-000465
  21. Lee H, Sohn SI, Cho YW, Lee SR, Ahn BH, Park BR, Baloh RW. Cerebellar infarction presenting isolated vertigo: frequency and vascular topographical patterns. Neurology. 2006;67:1178-1183. https://doi.org/10.1212/01.wnl.0000238500.02302.b4
  22. Norrving B, Magnusson M. Isolated acute vertigo in the elderly; vestibular or vascular disease. Acta Neurol Scand. 1995;91:43-48. https://doi.org/10.1111/j.1600-0404.1995.tb05841.x
  23. Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ : Canadian Medical Association Journal. 2011;183(9):571-592. https://doi.org/10.1503/cmaj.100174
  24. Kerber KA, Brown DL, Lisabeth LD, Smith MA, Morgenstern LB. Stroke Among Patients With Dizziness, Vertigo, and Imbalance in the Emergency Department: A Population-Based Study. Stroke; a Journal of Cerebral Circulation. 2006;37(10):2484-2487. https://doi.org/10.1161/01.STR.0000240329.48263.0d
  25. Kim JS, Lee H. Inner ear dysfunction due to vertebrobasilar ischemic stroke. Semin Neurol. 2009;29:534-540. https://doi.org/10.1055/s-0029-1241037
  26. Newman-Toker DE, Kattah JC, Talkad AV, Wang DZ, Hsieh Y-H, Newman-Toker DE. H.I.N.T.S. to Diagnose Stroke in the Acute Vestibular Syndrome—Three-Step Bedside Oculomotor Exam More Sensitive than Early MRI DWI. Stroke; a Journal of Cerebral Circulation. 2009;40(11):3504-3510. https://doi.org/10.1161/STROKEAHA.109.551234
  27. Paciaroni M, Caso V, Milia P, Nardi K, Micheli S, Agnelli G. Isolated monoparesis following stroke. J Neurol Neurosurg Psychiatry. 2005;76:805-807. https://doi.org/10.1136/jnnp.2004.047779
  28. Maeder-Ingvar M, van Melle G, Bogousslavsky J. Pure Monoparesis A Particular Stroke Subgroup? Arch Neurol. 2005;62(8):1221-1224. https://doi.org/10.1001/archneur.62.8.1221
  29. Jusufovic M, Lygren A, Aamodt AH, Nedregaard B, Kerty E. Pseudoperipheral palsy: a case of subcortical infarction imitating peripheral neuropathy. BMC Neurology. 2015;15:151. https://doi.org/10.1186/s12883-015-0409-y
  30. Celebisoy M, Ozdemirkiran T, Tokucoglu F, Kaplangi DN, Arici S. Isolated hand palsy due to cortical infarction: localization of the motor hand area. Neurologist. 2007;13(6):376-379. https://doi.org/10.1097/NRL.0b013e31814db093
  31. Golubev VL, Vein AM. Nevrologicheskie sindromy. Rukovodstvo dlya vrachei. M.: MEDpress-inform; 2012. (In Russ.)
  32. Vartenberg R. Diagnostic tests in neurology. Pod red. Bogolepova N.K. M.: Medgiz; 1966. (In Russ.)
  33. Kang SY, Kim JS. Anterior cerebral artery infarction: stroke mechanism and clinical-imaging study in 100 patients. Neurology. 2008;70:2386-2393. https://doi.org/10.1212/01.wnl.0000314686.94007.d0
  34. Hiraga A, Uzawa A, Tanaka S, Ogawara K, Kamitsukasa I. Pure monoparesis of the leg due to cerebral infarctions: a diffusion-weighted imaging study. J Clin Neurosci. 2009;16:1414-1416. https://doi.org/10.1007/s00415-010-5585-5
  35. Paciaroni M, Bogousslavsky J. Pure sensory syndromes in thalamic stroke. Eur Neurol. 1998;39:211-217. https://doi.org/10.1159/000007936
  36. Stone J, Zeman A, Sharpe M. Functional weakness and sensory disturbance. Journal of Neurology, Neurosurgery, and Psychiatry. 2002;73(3):241-245. https://doi.org/10.1136/jnnp.73.3.241
  37. Gorson K, Pessin M, Dewitt L, Caplan LR. Stroke with sensory symptoms mimicking myocardial ischemia. Neurology. 1996;46(2):548-551. https://doi.org/10.1212/wnl.46.2.548
  38. Beliavsky A, Perry JJ, Dowlatshahi D, Wasserman J, Sivilotti MLA, Sutherland J, Worster A, Emond M, Stotts G, Jin AY, Oczkowski WJ, Sahlas DJ, Murray HE, MacKey A, Verreault S, Wells GA, Stiell IG, Sharma M. Acute Isolated Dysarthria Is Associated with a High Risk of Stroke. Cerebrovascular Diseases Extra. 2014;4(2):182-185. https://doi.org/10.1159/000365169
  39. Engelter ST, Gostynski M, Papa S, Frei M, Born C, Ajdacic-Gross V, Gutzwiller F, Lyrer PA. Epidemiology of aphasia attributable to first ischemic stroke.Incidence, severity, fluency, etiology, and thrombolysis. Stroke. 2006;37:1379-1384. https://doi.org/10.1161/01.STR.0000221815.64093.8c
  40. Barquero MS, Egido JA, Garcia AM. Mother tongue lost while second language intact: insights into aphasia. BMJ Case Reports. 2010; pii: bcr07.2009.2062. https://doi.org/10.1136/bcr.07.2009.2062
  41. Karanasios P, LoukopoulouP, Zampakis P, Tiligadas T, Makridou A, Doukas V, Argyriou AA. Foreign accent syndrome caused by a left temporal—parietal ischaemic stroke. Acta Neuropsychiatrica. 2011;23(5):249-251. https://doi.org/10.1111/j.1601-5215.2011.00551.x
  42. Naidoo R, Warriner EM, Oczkowski WJ, Sévigny A, Humphreys KR. A case of foreign accent syndrome resulting in regional dialect. Can J Neurol Sci. 2008;35:360-365. https://doi.org/10.1017/S0317167100008970
  43. Baier B, de Haan B, Mueller N, Thoemke F, Birklein F, Dieterich M, Karnath H-O. Anatomical correlate of positive spontaneous visual phenomena: a voxelwise lesion study. Neurology. 2010;74:218-222. https://doi.org/10.1212/WNL.0b013e3181cb3e64
  44. Amalnath SD, Kumar S, Deepanjali S, Dutta TK. Balint syndrome. Ann Indian Acad Neurol. 2014;17(1):10-11. https://doi.org/10.4103/0972-2327.128526
  45. Chechlacz M, Humphreys GW. The enigma of Bálint’s syndrome: neural substrates and cognitive deficits. Frontiers in Human Neuroscience. 2014;8:123. https://doi.org/10.3389/fnhum.2014.00123
  46. Maddula M, Lutton S, Keegan B. Anton’s syndrome due to cerebrovascular disease: a case report. Journal of Medical Case Reports. 2009;3:9028. https://doi.org/10.4076/1752-1947-3-9028
  47. Ghika-Schmid F, Ghika J, Regli F, Bogousslavsky J. Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry. J Neurol Sci. 1997;146:109-116. https://doi.org/10.1016/S0022-510X(96)00290-0
  48. Bansil S, Prakash N, Kaye J, Wrigley S, Manata C, Stevens-Haas C, Kurlan R. Movement Disorders after Stroke in Adults: A Review. Louis ED, ed. Tremor and Other Hyperkinetic Movements. 2012;2:tre-02-42-195-1. https://doi.org/10.7916/D86W98TB
  49. Vidaković A, Dragasević N, Kostić VS. Hemiballism: report of 25 cases. Journal of Neurology, Neurosurgery, and Psychiatry. 1994;57(8):945-949. https://doi.org/10.1136/jnnp.57.8.945
  50. Chuang C, Fahn S, Frucht S. The natural history and treatment of acquired hemidystonia: report of 33 cases and review of the literature. Journal of Neurology, Neurosurgery, and Psychiatry. 2002;72(1):59-67. https://doi.org/10.1136/jnnp.72.1.59
  51. Krauss JK, Pohle T, Borremans JJ. Hemichorea and hemiballism associated with contralateral hemiparesis and ipsilateral basal ganglia lesions. Mov Disord. 1999;14:497-501. https://doi.org/10.1002/1531-8257(199905)14:3<497::aid-mds1019>3.0.co;2-x
  52. Baik JS, Lee MS. Movement disorders associated with moyamoya disease: a report of 4 new cases and a review of literatures. Mov Disord. 2010;25:1482-1486. https://doi.org/10.1002/mds.23130
  53. Barnes MP, Dobkin BH, Bogousslavsky J. Recovery after Stroke. Cambridge: Cambridge University Press; 2005.
  54. Deusch G, Toro C, Valles-Sole J, Zee DS, Hallett M. Symptomatic essential palatal tremor. 1. Clinical, physiological and MRI analysis. Brain. 1994;117:775-788. https://doi.org/10.1093/brain/117.4.775
  55. Park J. Movement Disorders Following Cerebrovascular Lesion in the Basal Ganglia Circuit. J Mov Disord. 2016;9(2):71-79. https://doi.org/10.14802/jmd.16005
  56. Ma QF, Huang Q, Zhang Q, Fan CQ, Guo XH, Wu J. Association between clinical features and prognosis of patients with limb-shaking transient ischemic attack. Chin Med J (Engl). 2013;126(22):4354-4357.
  57. Das A, Baheti NN. Limb-shaking transient ischemic attack. Journal of Neurosciences in Rural Practice. 2013;4(1):55-56. https://doi.org/10.4103/0976-3147.105615
  58. Ali S, Khan MA, Khealani B. Limb-shaking Transient Ischemic Attacks: case report and review of literature. BMC Neurol. 2006;6:5. https://doi.org/10.1186/1471-2377-6-5
  59. Alonso JV, del Pozo FJ, Simon JC, Valenzuela S, Perez Gomez F, Lopera E. Limb-Shaking TIA Presenting as Hemichorea—Hemiballismus: TIA Chameleons Diagnostic Challenge in the Emergency Department. J Stroke Cerebrovasc Dis. 2015;24(11):327-331. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.006
  60. Grigorieva VN, Sorokina TA, Kalinina SYa. Alien hand syndrome in acute ischemic stroke patients. Nevrologicheskiy Zhurnal. 2015;20(2):18-23. (In Russ.) https://doi.org/10.18821/1560-9545-2015-20-2-18-23
  61. Kawakami M, Sato T, Tochigi S, Ito T. Lacunar pontine infarction with hemifacial spasm as the initial symptom. Stroke. 1990;21:1236. https://doi.org/10.1161/01.STR.21.8.1236.a
  62. Sayer D, Bloom B, Fernando K, Jones S, Benton S, Dev S, Deverapalli S, Harris T. An observational study of 2,248 patients presenting with headache, suggestive of subarachnoid hemorrhage, who received lumbar punctures following normal computed tomography of the head. Acad Emerg Med. 2015;22:1267-1273. https://doi.org/10.1111/acem.12811
  63. Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM, Hill MD, Patronas N, Latour L, Warach S. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet. 2007;369:293-298. https://doi.org/10.1016/s0140-6736(07)60151-2
  64. Mullins ME, Schaefer PW, Sorensen AG, Halpern EF, Ay H, He J, Koroshetz WJ, Gonzalez RG. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology. 2002;224:353-360. https://doi.org/10.1148/radiol.2242010873
  65. Bulut HT, Yildirim A, Ekmekci B, Eskut N, Gunbey HP. False-negative diffusion-weighted imaging in acute stroke and its frequency in anterior and posterior circulation ischemia. J Comput Assist Tomogr. 2014;38:627-633. https://doi.org/10.1097/RCT.0000000000000095

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