Young adult stroke patients may be misdiagnosed in ER
(DALLAS), (April 7, 2009) — When Juaquin Hawkins, former NBA player with the Houston Rockets, suddenly lost his speech, hearing and feeling on the right side of his body in January 2008, his coach and the staff in the local hospital emergency department thought he was just dehydrated.
But it was worse — he was having a stroke.
Hawkins, 35, is yet another young adult with stroke symptoms misdiagnosed in emergency rooms — making these people miss effective early treatment, according to research presented at the American Stroke Association’s International Stroke Conference 2009.
"Accurate diagnosis of stroke on initial presentation in young adults can reduce the number of patients who have continued paralysis and continued speech problems," said Seemant Chaturvedi, M.D., senior author of the study and a professor of neurology and director of the stroke program at Wayne State University in Detroit, Mich.
"We have seen several young patients who presented to emergency rooms with stroke-like symptoms within three to six hours of symptom onset, and these patients did not get proper treatment due to misdiagnosis. The first hours are critical."
Intravenous delivery of the clot-busting drug tissue plasminogen activator (tPA) is the only U.S. government-approved treatment for acute stroke. It must be delivered within three hours of symptom onset to reduce permanent disability caused by stroke.
Experimental interventional stroke treatment such as intra-arterial clot busters and mechanical clot retrieval may be an option for some patients three to eight hours after symptoms, Chaturvedi said.
"Part of the problem is that the emergency room staff may not be thinking ‘stroke’ when the patient is under 45 years old," Chaturvedi said. "Physicians must realize that a stroke is the sudden onset of these symptoms."
Patients arriving with "seemingly trivial symptoms like vertigo and nausea" should be assessed meticulously, he said.
"Some people believe that younger people may respond better to stroke treatments, so that makes it doubly important to recognize when a stroke is happening. After 48 to 72 hours, there are no major interventions available to improve stroke outcome."
Hawkins’ stroke was eventually detected. He’s getting his life back together and is now an Ambassador for the American Stroke Association’s Power To End Stroke education campaign, which is targeted to blacks. African Americans are twice as likely to have a stroke compared to whites. In fact, more than 100,000 African Americans will have a stroke this year.
"Stroke can happen to anyone, at any time," Hawkins said.
The warning signs of stroke are:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
Do not ignore symptoms even if they go away. It could be a TIA (transient ischemic attack) or mini stroke. Call 9-1-1 and get to the hospital emergency room fast. When talking to the 9-1-1 operator, the emergency response team and the emergency room staff at the hospital, say "I think I’m having a stroke" or if you are with someone with symptoms, say "I think my friend/relative is having a stroke." This will help in getting fast treatment.
Damage from stroke may be permanent and devastating. Early intervention may help reduce the disability and possibly death from stroke. "Early intervention is the most critical component of effective stroke care," said Abraham Kuruvilla, M.D., the study’s lead author and a stroke fellow in the neurology department at Wayne State University. "Early intervention will reduce the burden of disability of the young patients afflicted with stroke disability and the associated high cost of medical care in this population."
To take a stroke risk assessment, visit powertoendstroke.org. If you are at risk, learn the warning signs, teach them to those close to you and work with your doctor to reduce your risk.
To learn more about stroke and Power To End Stroke, visit PowerToEndStroke.org.
The Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership is the national sponsor of Power To End Stroke.