Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion. (23rd February 2014)

• Record Type: Journal Article
• Authors: Bhan, Alok; Advani, Rajiv; Kurz, Kathinka D.; Farbu, Elisabeth; Kurz, Martin W.
• Other Names: Berlit P. Academic Editor.; Wessel K. Academic Editor.
• Is Part Of: Case reports in neurological medicine. Volume 2014(2014)
• Publication Date: 2014-02-23
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; Neurology; Nervous System Diseases; Nervous system -- Diseases; Neurology; Electronic journals; Periodicals; Periodicals; 616.8
• DOI: 10.1155/2014/673230
• Languages: English
• ISSNs: 2090-6676

Abstract

Abstract : Background . Metabolic syndromes such as Wernicke's encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient . A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT) including a CT perfusion (CTP) scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke's encephalopathy. Conclusion . The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report.