To tPA or Not to tPA: Two Medical-Legal Misadventures of Diagnosing a Cerebrovascular Accident as a Stroke Mimic.

Autor:	Moore MJ; Carl R. Darnall Army Medical Center, Department of Emergency Medicine, Fort Hood, Texas., Stuart J; Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington., Humphreys A; Wharton Aldhizer & Weaver, Harrisonburg, Virginia., Pfaff JA; San Antonio Military Medical Center, Department of Emergency Medicine, San Antonio, Texas.
Jazyk:	angličtina
Zdroj:	Clinical practice and cases in emergency medicine [Clin Pract Cases Emerg Med] 2019 Jul 08; Vol. 3 (3), pp. 194-198. Date of Electronic Publication: 2019 Jul 08 (Print Publication: 2019).
DOI:	10.5811/cpcem.2019.4.42186
Abstrakt:	We present two recent successfully litigated malpractice cases in which patients with cerebrovascular accidents were misdiagnosed as stroke mimics. The first was diagnosed as a hemiplegic migraine, which occurs in only 0.01% of the population. The second was diagnosed as a conversion disorder, which ultimately has a neurologic etiology in 4% of cases. In both cases, issues of poor patient communication and poor documentation were paramount in the legal outcome. We discuss caveats of stroke mimics, tissue plasminogen activator administration liability, and pitfalls in patient and family interactions. Competing Interests: Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The views expressed here are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the U.S. Government.
Databáze:	MEDLINE
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