NATIONWIDE — One month after hospital evaluation for stroke-like symptoms, people whose symptoms were attributed to another condition were three times more likely to have an increased risk of post-traumatic stress disorder (PTSD) than people diagnosed with a confirmed stroke.

The finding was a result of preliminary research presented at the International Stroke Conference from the American Stroke Association (ASA).

Symptoms mimicking stroke include numbness, weakness, difficulty speaking, vision changes, headache, dizziness or unsteady gait.

“Stroke mimics matter. As clinicians, we may be quick to dismiss a patient’s less life-threatening diagnosis, such as migraine or vertigo. However, these patients may experience significant psychological distress, which can increase their risk for poorer cardiovascular health,” said abstract lead author Melinda Chang, a research nurse at the Center for Behavioral Cardiovascular Health at Columbia University Irving Medical Center in New York City. 

Researchers analyzed health data for 1,000 adults (average age of 62 years; 51 percent female) who received care in a hospital’s emergency department for suspected stroke. During hospitalization, the patients completed a PTSD survey, and a neurologist (without knowledge of the PTSD scores) reviewed their medical charts to provide a medical diagnosis.

The most common conditions that mimicked stroke that were noted were migraine and other headaches, peripheral or cranial neuropathy (weakness, numbness or pain caused by nerve damage), and peripheral vertigo (dizziness and a spinning sensation caused by factors outside of the brain).

After adjusting for several factors, including age, gender, ethnicity, severity of stroke-like symptoms, previous PTSD and degree of disability when discharged from the hospital, the risk of PTSD one month after discharge was three times as high in people with stroke mimics compared to those with confirmed stroke.

Elevated PTSD symptoms were found in 15 percent of people diagnosed with stroke mimics; in contrast, PTSD symptoms were found in only six percent of those diagnosed with stroke and 5.5 percent of those with transient ischemic attacks (TIA).

People who had PTSD prior to hospitalization had 10 times the risk of also having elevated PTSD symptoms one month after discharge.   

“Stroke specialists typically view stroke mimics as less serious than a confirmed stroke, so we did not expect patients with stroke mimics to be at higher risk for having PTSD at one-month follow-up,” Chang said.   

According to the researchers, further study is needed to explore the possible contributors to the higher risk of PTSD in people with stroke mimics, including the stroke evaluation or hospitalization itself, a lack of certainty about their diagnosis or the lack of a standardized treatment for those with their diagnosis. [Ed. note: It would also be interesting to learn more about stroke sufferers and PTSD. Why do they suffer it less?]

“It is important for people who are evaluated for stroke to know they are not alone if they experience flashbacks, disrupted sleep or feel on edge after their medical event. They should feel comfortable and empowered to report any concerning symptoms to their health care team so they can get the help they need,” Chang said.

The study limitations included using self-reported symptoms rather than a health care professional evaluation for the diagnosis of PTSD. These results, while based on a diverse group of people, were collected in only one urban, academic medical center and might not be generalizable to people living in other communities or receiving care at other health centers.

Abstracts presented at the ASA’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting.

To learn more about the International Stroke Conference, visit www.professional.heart.org/en/meetings/international-stroke-conference#important.