The presence of a stroke may not always be initially apparent. A stroke should be suspected in a patient with the sudden onset of neurological signs and symptoms.
Stroke presentations that may mislead:
(1) delirium or acute confusion
(2) syncope
(3) hypertensive emergency
(4) acute vertigo, dizziness
(5) decreased level of consciousness, altered mental status
(6) peripheral neuropathy or radiculopathy
(7) systemic infection
(8) suspected acute coronary syndrome (ACS)
(9) altered gait or imbalance
Patients at risk for delayed diagnosis:
(1) younger age
(2) stroke in the posterior circulation
(3) associated with drug of abuse
(4) coma
(5) mild symptoms
