ER Less Likely to Diagnose Stroke in Younger Folks

ByABC News
February 18, 2009, 8:25 PM

Feb. 19 -- WEDNESDAY, Feb. 18 (HealthDay News) -- An 18-year-old boy complaining of numbness at a Detroit emergency room was discharged after health-care professionals determined he was drunk.

A 24-year-old woman with sharp pain in her left eye and loss of feeling in her right arm was told by ER doctors that she had a migraine.

And a 29-year-old man with slurred speech, a facial droop and vertigo was diagnosed with peripheral vertigo during his emergency room visit.

In fact, each one of these younger adults had had a stroke, which went undetected because of their age, according to new research to be presented Wednesday at the American Stroke Association's International Stroke Conference in San Diego.

The research, looking at ER visits by people under 50, found that the risk of misdiagnosis of a stroke increases as patient age goes down.

"Emergency room personnel need to have a heightened sensitivity to the possibility of stroke in people . . . under 45," said senior study author Dr. Seemant Chaturvedi, director of the stroke program at Wayne State University in Detroit. "There needs to be a solid familiarity with the combination of symptoms that would indicate stroke rather than something more benign."

"Identifying what we consider to be an 'old person's disease' in young people is always a challenge because there's denial on the part of patients and denial on the part of caregivers," added Dr. Robert Greenberg, an assistant professor of emergency medicine at Texas A&M Health Science Center College of Medicine and vice chair of emergency medicine with Scott & White in Temple. "Everybody should be given a stroke assessment. If you see someone who comes in with dizziness and trouble walking, it should cross your mind."

Stroke is the third leading cause of death in the United States. Failure to identify and treat a stroke quickly can lead to severe disability, and even loss of life.

The study authors looked at 57 people under the age of 50 who went to a Detroit emergency room with various symptoms. The participants were equally divided in gender, and their median age was 34.