Stroke Diagnosis and Management Challenges

Stroke remains a leading cause of mortality and long-term disability worldwide, with ischaemic events accounting for the majority of cases. Rapid and accurate diagnosis is critical to enable reperfusion therapies within the narrow time window offered by thrombolysis and thrombectomy. However, clinical presentation is highly variable, often complicated by stroke mimics that share similar neurological signs. Conventional imaging such as non-contrast CT may lack sensitivity in the hyperacute phase, while advanced modalities like diffusion-weighted MRI require specialised infrastructure and expertise. Disparities in access to emergency neuroimaging and expert consultation are pronounced in rural and resource-limited settings. Furthermore, misdiagnosis can delay treatment or expose patients to unnecessary risks. Management challenges extend beyond the acute phase, encompassing secondary prevention, individualised rehabilitation and consideration of social determinants that influence outcome. Innovations in telemedicine, predictive analytics and standardised triage protocols aim to address these gaps, but integration into routine practice demands cross-disciplinary collaboration and robust validation across diverse healthcare systems.

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Stroke Diagnosis and Management Challenges publication trend

The graph below shows the total number of articles in stroke diagnosis and management challenges across all publications each year (not limited to Nature Index journals).

Technical terms

Stroke mimic: A non-cerebrovascular condition presenting with acute neurological signs that resemble stroke.

Thrombolysis: Administration of pharmacological agents to dissolve intravascular clots and restore cerebral blood flow.

Diffusion-weighted imaging (DWI): An MRI technique sensitive to water motion within tissues, enabling early detection of ischaemic injury.

Telestroke: Remote delivery of stroke expertise via telecommunication, facilitating rapid diagnosis and treatment decisions.

Social determinants of health (SDoH): Socioeconomic and environmental factors influencing health outcomes and access to care.

National Institutes of Health Stroke Scale (NIHSS): A standardised tool for quantifying stroke severity based on neurological examination.

References

1. A Machine Learning Approach to Support Urgent Stroke Triage Using Administrative Data and Social Determinants of Health at Hospital Presentation: Retrospective Study. Journal of Medical Internet Research (2023).
2. Ischemic stroke mimics: A comprehensive review. Journal of Clinical Neuroscience (2021).
3. External validation of stroke mimic prediction scales in the emergency department. BMC Neurology (2020).