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„Stroke mimics“ – Differenzialdiagnose des Schlaganfalls in der Notfallmedizin

Stroke mimics—differential diagnosis of stroke in emergency medicine

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Zusammenfassung

Schlaganfälle gehören zu den weltweit führenden Ursachen für Behinderung und Tod. Da der Erfolg der Rekanalisationsbehandlung mit intravenöser Thrombolyse oder mechanischer Thrombektomie zeitabhängig ist („Time is brain“), besteht ein großer Druck zur raschen Therapieentscheidung. Dies erhöht die Wahrscheinlichkeit einer Fehldiagnose, da schlaganfallähnliche Symptome auch bei anderen Krankheiten vorliegen können. Der vorliegende Beitrag soll einen Überblick über die häufigsten Krankheitsbilder geben, die einen Schlaganfall vortäuschen („stroke mimics“). Eine der vielen Herausforderungen für ein in der Primärversorgung tätiges Notfallteam besteht darin, die wesentlichen „mimics“ und ihre diagnostischen Besonderheiten zu kennen und somit die Rate der Fehldiagnosen zu reduzieren.

Abstract

Strokes are a leading cause of disability and death worldwide. Since the success of recanalization treatment with intravenous thrombolysis or mechanical thrombectomy is time critical (“time is brain”), there is a great pressure for quick therapy decisions. This may increase the likelihood of a misdiagnosis, as stroke-like symptoms can also be present in other diseases. This article is intended to provide an overview of the most common clinical conditions that present stroke-like symptoms (stroke mimics). One of the many challenges of the emergency team working in primary care is to recognize the essential mimics and to triage them accordingly.

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Authors and Affiliations

  1. Zentrum für Neurologie und Neurorehabilitation, Luzerner Kantonsspital, Spitalstraße, 6000, Luzern, Schweiz

    L.-B. Lakatos, M. Müller & M. Bolognese

  2. Notfallzentrum, Kantonsspital Luzern, Luzern, Schweiz

    M. Christ

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  1. L.-B. Lakatos
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  2. M. Christ
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  3. M. Müller
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  4. M. Bolognese
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Correspondence to L.-B. Lakatos.

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L.-B. Lakatos, M. Christ, M. Müller und M. Bolognese geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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M. Christ, Luzern

M. Bernhard, Düsseldorf

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Lakatos, LB., Christ, M., Müller, M. et al. „Stroke mimics“ – Differenzialdiagnose des Schlaganfalls in der Notfallmedizin. Notfall Rettungsmed 24, 990–996 (2021). https://doi.org/10.1007/s10049-021-00877-x

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  • DOI: https://doi.org/10.1007/s10049-021-00877-x

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