Stroke Symptoms in Young More Likely Missed by Emergency Doctors

StrokeA recent study shows that stroke symptoms in the young are more likely to be missed by emergency doctors. The researchers at the John Hopkins University noted that women and those of ethnic minority were also likely to be misdiagnosed if they attended an ER with symptoms of the ailment.

Study lead author, Dr. David Newman-Toker noted that those under 45 are less likely to suffer from a stroke than older people. This leads to the symptoms being missed, because more emergency room doctors are not looking out for them.

The study looked at data from hospital ERs between 2008 and 2009. It showed that 13 percent of patients would return within 30 days, when they first attended with dizziness and headaches. These are not the typical symptoms, and the researchers believed that they could have been the signs of a minor attack that led to the more severe attacks that needed instant treatment.

Many of the patients were sent home without a diagnoses, or being told they had migraines or inner ear infections. Around 25 percent of the patients would return within 48 hours, and had more obvious symptoms.

There will be many now worried about being misdiagnosed, considering how important it is to catch this problem early. It sounds extremely worrying that emergency doctors are more likely to miss the stroke symptoms in the young, in women and in those of ethnic minority. However, it is important to note the problem with the data collected during the study.

Neurologist Dr. Larry Goldstein, who was not involved in the study, made it clear that not all the patient data was available. It is unclear just which symptoms were present at the time of the initial diagnoses, and whether there was a reason to suspect the seriousness of the issue. A headache is one of the most common symptoms for so many different ailments, diseases and infections. It is understandable that those suffering a stroke could be missed if they just had this symptom.

The question is why certain ages and people are more likely to be missed. Newman-Toker noted that women are not as likely to have the common symptoms of this ailment as men are. These symptoms inability to lift both arms, being able to smile and the difficulty talking. Younger people are also less likely to have a stroke, so those who come in with dizziness and headaches are likely to be checked for other, more likely ailments and diseases first.

Goldstein does accept that misdiagnosis is a problem in general. It is possible that the patients were initially misdiagnosed, but without being able to see all the case records it is difficult to prove. There is still a lot of research needed into the ailment, with reasons for one happening realized. One of those through a recent study is insomnia, but there are so many others.

Newman-Toker’s study does show that there is a problem, but the question is how to change that. It is difficult to diagnose the condition, especially in patients with headaches. It is understandable why stroke symptoms are missed in the young by emergency doctors when that is taken into account.

By Alexandria Ingham



De Gruyter

The Boston Globe

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