BACKGROUND: Stroke is a leading cause of death worldwide. Prompt recognition and management is necessary to mitigate the risk of patient morbidity and mortality. Notably, approximately 20% of suspected stroke cases are due to alternate pathologies including seizures, anatomic malformations, neoplasms, vasculopathies, or metabolic disturbances. These stroke “mimics” closely resemble true stroke clinically thus impeding initial diagnosis. The mainstay modalities used for radiologic assessment of stroke are non-contrast CT, CT angiogram of the head and neck, and MR imaging. Given the time-sensitive nature of stroke, accurate radiological differentiation of ischemic or hemorrhagic mimics is of paramount importance. 

CONCLUSION: Successfully differentiating the etiology of potential stroke cases significantly improves patient outcomes. Characteristic radiologic findings of various stroke mimics are often distinct allowing prompt intervention.

A pictorial review of stroke mimics for the Radiologist