{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:01:02Z","timestamp":1785366062054,"version":"3.55.0"},"reference-count":28,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"abstract":"<jats:p>Introduction: Scarce data exist about clinical\/radiological differences between acute ischemic strokes diagnosed in the emergency room (AISER) and stroke chameleons (SCs). We aimed at describing the differences observed in a comprehensive stroke center in Chile. Methods: Prospective observational study of patients with ischemic stroke syndromes admitted to the emergency room (ER) of Cl\u00ednica Alemana between December 2014 and October 2023. Results: 1,197 patients were included; of these 63 (5.2%, 95% CI: 4.1\u20136.6) were SC; these were younger (p &lt; 0.001), less frequently hypertensive (p = 0.03), and they also had lower systolic (SBP) (p &lt; 0.001), diastolic blood pressures (DBP) (p = 0.011), and NIHSS (p &lt; 0.001). Clinically, they presented less frequently gaze (p = 0.008) and campimetry alterations (p = 0.03), facial (p &lt; 0.001) and limb weakness (left arm [p = 0.004], right arm (p = 0.041), left leg (p = 0.001), right leg p = 0.0029), sensory abnormalities (p &lt; 0.001), and dysarthria (p &lt; 0.001). Neuroradiological evaluations included less frequently large vessel occlusions (p = 0.01) and other stroke locations (p = 0.005); they also differed in their etiologies (p &lt; 0.001). Brainstem strokes (p &lt; 0.001) and extinction\/inattention symptoms (p &lt; 0.001) were only seen in AISER. In multivariate analysis, younger age (OR: 0.945; 95% CI: 0.93\u20130.96), DBP (OR: 0.97; 95% CI, 0.95\u20130.99), facial weakness (OR: 0.39; 95% CI: 0.19\u20130.78), sensory abnormities (OR: 0.16.18; 95% CI, 0.05\u20130.4), infratentorial location (OR: 0.36; 95% CI, 0.15\u20130.78), posterior circulation involvement (OR: 3.02; 95% CI, 1.45\u20136.3), cardioembolic (OR: 3.5; 95% CI, 1.56\u20137.99), and undetermined (OR: 2.42; 95% CI, 1.22\u20134.7; 95%) etiologies, remained statistically significant. A stepwise analysis including only clinical elements present on the patient\u2019s arrival to the ER, demonstrates that age (OR: 0.95; 95% CI: 0.94\u20130.97), DBP (OR: 0.97; 95% CI, 0.95\u20130.99), the presence of atrial fibrillation (OR: 2.22; 95% CI, 1.04\u20134.75, NIHSS (OR: 0.88; 95% CI, 0.71\u20130.89) and the presence in NIHSS of 1a level of consciousness (OR: 5.66; CI: 95% 1.8\u201316.9), 1b level of consciousness questions (OR: 3.023; 95% CI, 1.35\u20136.8), facial weakness (OR: 0.3; CI: 95% 0.17\u20130.8), and sensory abnormalities (OR: 0.27; 95% CI, 0.1\u20130.72) remained statistically significant. Conclusion: SC had clinical and radiological differences compared to AISER. An additional relevant finding is that neurological symptoms in a patient with atrial fibrillation, even with a negative diffusion-weighted imaging, should be carefully evaluated as a potential stroke until other causes are satisfactorily ruled out. <\/jats:p>","DOI":"10.1159\/000540409","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T17:15:29Z","timestamp":1721668529000},"page":"315-322","source":"Crossref","is-referenced-by-count":3,"title":["Clinical and Radiological Differences between Patients Diagnosed with Acute Ischemic Stroke and Chameleons at the Emergency Room: Insights from a Single-Center Observational Study"],"prefix":"10.1159","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8376-9450","authenticated-orcid":false,"given":"Alejandro M.","family":"Brunser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9118-9093","authenticated-orcid":false,"given":"Pablo M.","family":"Lavados","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1869-2255","authenticated-orcid":false,"given":"Paula","family":"Mu\u00f1oz-Venturelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica V.","family":"Olavarr\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloy","family":"Mansilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Cavada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo Enrique","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000074"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.56.8.1015"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.590372"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2012-000465"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2013-000782"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000001830"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-018-2029-x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.31.4.858"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2012.02.011"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003814"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.10.019"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2006.07.008"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-011-0767-1"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011427.pub2"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-023-00825-7"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013842"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13029"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-021-02206-8"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.13.4.434"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.851498"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000327888.48230.d2"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.551234"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jen.2012.02.011"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12807"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.12.039"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282X-ANP-2021-0080"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.016414"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2021.11.007"}],"container-title":["Cerebrovascular 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