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Tissue plasminogen activator (t-PA) generally should be given to stroke patients within several hours of symptom onset. However, some patients with acute neurological signs and symptoms that suggest stroke actually have nonstroke conditions, most of which cannot be diagnosed with certainty prior to t-PA administration. An important question is whether t-PA is harmful to these patients.
To address this issue, researchers analyzed data from a registry of 512 patients who received t-PA for suspected stroke within 3 hours of symptom onset at a Houston hospital. Fully 106 patients (21%) had no infarct on diffusion-weighted magnetic resonance imaging done within 24 hours or on subsequent imaging; 69 were diagnosed with “stroke mimics” (most common…