Clinical and prognostic correlates of XXXX subtype misdiagnosis within 12 hours from onset.

@entity1 @entity64 @entity101 @entity6 @entity63 @entity13675 @entity51 @entity1188 @entity751 @entity955 @entity8987 @entity204
BACKGROUND AND PURPOSE: Pure motor hemiparesis and @entity64 are not accurate predictors of @entity1188 when described in the first 12 hours of @entity64 onset. We evaluate here whether this inaccuracy of clinical diagnosis might have influenced the planning of @entity1 management either in routine practice or in therapeutic trials. METHODS: A consecutive hospital series of 517 first-ever @entity63 hemispheric @entity64 @entity1 presented lacunar or nonlacunar syndromes at the first examination within 12 hours of the event. A distinction was subsequently made, by means of a CT scan or autopsy performed within 15 +/- 2 days of @entity64 , between @entity1 affected by lacunar or nonlacunar @entity1188 . We compared @entity64 risk factors, considered to be indicative of potential pathogenetic mechanisms, and the clinical outcome of @entity1188 versus nonlacunar @entity1188 @entity1 and those of @entity8987 versus @entity751 @entity1 . RESULTS: Two hundred nineteen @entity1 (42%) presented a @entity8987 and 298 (58%) a @entity751 , while 170 (33%) had @entity1188 and 347 (67%) nonlacunar @entity1188 . @entity1188 @entity1 were more frequently associated with @entity101 and a previous transient @entity63 attack and less frequently with @entity955 when compared with their nonlacunar @entity1188 counterparts, whereas no differences were apparent between @entity8987 and @entity751 @entity1 . Logistic regression analysis showed that @entity101 and a previous transient @entity63 attack on the one hand and @entity955 on the other were strongly correlated with the diagnosis of @entity1188 and nonlacunar @entity1188 , respectively, while no risk factor was correlated with the diagnosis of @entity8987 . Twenty-two percent of @entity1188 @entity1 and 68% of nonlacunar @entity1188 subjects had a poor outcome ( @entity204 plus disability of survivors) as opposed to 40% of @entity8987 and 63% of @entity751 @entity1 . Logistic regression selected age, severity of @entity51 at entry, @entity13675 , @entity6 , and @entity1188 , but not @entity8987 , as predictors of outcome. CONCLUSIONS: The inaccurate clinical diagnosis of @entity1188 made in the first 12 hours of @entity64 might lead to no distinction being made between @entity64 subgroups with potentially different pathogenetic mechanisms and prognostic estimates, thus negatively influencing the planning of @entity1 management.
