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For the average patient with acute ischemic stroke, brain computed tomography (CT) is inconclusive within the first 6 hours. Therefore, a test that can differentiate a true stroke from a stroke mimic, especially in the first few hours, would be highly desirable. These authors conducted an innovative study to evaluate the utility, for identifying stroke, of a panel of metabolites that can be assayed in the blood. They studied 508 stroke patients, 349 stroke-mimic patients, and 112 neurologically normal controls, divided into discovery, derivation, and validation cohorts. Stroke mimics were defined as neurologic symptoms but a normal diffusion-weighted imaging MRI study. Patients were evaluated within 24 hours after symptom onset.
In the patie…