Squamous Cell Carcinoma of the Neck: An Unlikely Stroke Mimic.
J Emerg Med
; 61(6): e133-e136, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34657783
ABSTRACT
BACKGROUND:
Stroke mimics are noncerebrovascular conditions that present with classical stroke symptoms. They account for up to 30% of stroke presentations in the emergency department (ED). Emergency physicians are faced with a diagnostic dilemma-rapid treatment of stroke, a leading cause or mortality and morbidity in the United States, or ruling out the ever-growing list of conditions that mimic strokes. CASE REPORT An 87-year-old man with a 60-year smoking history, chronic obstructive pulmonary disease, and extensive cardiovascular disease history presented to the ED with a chief symptom of new onset right-arm weakness. Computed tomography (CT) excluded hemorrhage and lesions, and additional CT angiography imaging revealed a large mass compressing the right subclavian artery. Given the initial workup, mass effect on the right brachial plexus better explained the patient's symptoms. Two weeks later, a CT scan of the chest, abdomen, and pelvis revealed masses on the pubic ramus, iliac bone, and several vertebral bodies. Biopsy of the rib mass revealed squamous cell carcinoma. The patient was diagnosed with bone metastasis of unknown origin and started on radiation therapy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? Even in fast-paced settings, clinicians must maintain a high level of suspicion for stroke mimics. This case illustrates the vital importance of neuroimaging in the diagnosis of stroke mimics and discusses clinical characteristics and patient risk factors that increase the likelihood of a stroke mimic diagnosis, serving as a tool for physicians facing this diagnostic dilemma.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma de Células Escamosas
/
Acidente Vascular Cerebral
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Aged80
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Humans
/
Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article