Identifying the Stroke Mimics

Figures & data

Figure 1 Angioinvasive aspergillosis in a 20-year-old female with headache and acute onset aphasia. (A) T2W axial section shows inflammatory changes in the sphenoid sinus (white arrow) with altered signal intensity in the adjacent medial aspect of the left temporal lobe (black arrow). (B) Post contrast T1W axial section shows enhancing area in the region of left temporal lobe signal abnormality. (C) Diffusion study shows an acute infarct in the left temporal lobe related to infective vasculitis of left middle cerebral artery (white arrow). (D) Follow up T2W axial section after 15 months shows chronic infarcts in the left MCA territory.

Table 1 Various Stroke Mimics Described in the Literature

Category	Etiology
Central Nervous System	Seizure Migraine: Typical and Hemiplegic Multiple sclerosis Brain tumors Subdural hemorrhage Parkinsonism Amyotrophic Lateral sclerosis Cognitive decline Meningeal carcinomatosis
Peripheral Nervous system	Peripheral vertigo Cranial neuropathies Diabetic neuropathy
Infections and immune mediated	Encephalitis Brain abscess Sepsis Limbic encephalitis Neurosarcoidosis
Vascular	Hypertensive encephalopathy PRES RCVS Hypotension Internal carotid artery hypoperfusion Venous infarcts
Metabolic	Hyponatremia Hypo/Hyperglycemia Hyperammonemia Uremic encephalopathy Hepatic encephalopathy
Psychiatric	Anxiety Conversion disorder Transient global amnesia Post Electroconvulsive therapy
Others	Alcohol related Syncope Osteomuscular Drugs Toxins