{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:48:18Z","timestamp":1782467298011,"version":"3.54.5"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Stroke is a leading cause of mortality and disability worldwide, with timely identification being crucial for effective treatment. However, some patients present as \u201cstroke chameleons\u201d (SC) displaying atypical stroke symptoms that mimic other conditions, often leading to delayed diagnosis and poorer outcomes. This study aims to assess the prevalence and clinical characteristics of SC in a comprehensive stroke center in Colombia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study involved ischemic stroke patients admitted to a high-level medical center in Bogot\u00e1, Colombia, from January 1, 2021, to December 31, 2023. We identified SC, defined as patients with a confirmed acute stroke in whom a stroke was not initially suspected, as indicated by a negative Cincinnati prehospital stroke scale and no activation of the stroke protocol. We evaluated the proportion of SC, their clinical and imaging characteristics, and compared them with non-SC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 635 ischemic stroke patients, 78 (12.2%) were identified as SC, while 557 (87.8%) were identified as non-SC. SC exhibited a lower National Institutes of Health stroke scale score and were more likely to present with altered mental status (38% vs. 24%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008), dizziness (30% vs. 16%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), and behavioral changes (8% vs. 2%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005). SC displayed less middle cerebral artery involvement (24% vs. 56%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.047) and more multi-territory involvement (34% vs. 17%,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). In addition, SC had a higher rate of normal computed tomography scans.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>SC are a significant subset of ischemic strokes, presenting with atypical symptoms that complicate the diagnosis. Recognizing these non-traditional presentations is essential for timely diagnosis, treatment, and potentially improved outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_298_2026","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:20:25Z","timestamp":1782465625000},"page":"374","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of chameleons in patients with ischemic stroke: A cross-sectional study"],"prefix":"10.25259","volume":"17","author":[{"given":"Nury Tatiana","family":"Rinc\u00f3n Cuenca","sequence":"first","affiliation":[{"name":"Department of Neurology, Ischemic Stroke Center, Fundaci\u00f3n Santa Fe de Bogot\u00e1, Bogot\u00e1, Colombia"},{"name":"Department of Neurology, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s Felipe","family":"Herrera Ortiz","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fundaci\u00f3n Santa Fe de Bogot\u00e1, Bogot\u00e1, Colombia"},{"name":"Department of Medicine, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidad del Rosario, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Mar\u00eda","family":"Camargo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ischemic Stroke Center, Fundaci\u00f3n Santa Fe de Bogot\u00e1, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar Alejandro","family":"Luzardo Neira","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidad El Bosque, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa Fernanda","family":"Velasquez Bejarano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidad de los Andes, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angie Melissa","family":"Montoya Caro","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidad de los Andes, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago Andr\u00e9s","family":"Monroy Santos","sequence":"additional","affiliation":[{"name":"Department of Medicine, Universidad de los Andes, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime Eduardo","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ischemic Stroke Center, Fundaci\u00f3n Santa Fe de Bogot\u00e1, Bogot\u00e1, Colombia"},{"name":"Department of Medicine, Universidad de los Andes, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Fernando","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ischemic Stroke Center, Fundaci\u00f3n Santa Fe de Bogot\u00e1, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"10.25259\/SNI_298_2026\/ref-1","doi-asserted-by":"crossref","first-page":"100533","DOI":"10.1016\/j.ejro.2023.100533","article-title":"Stroke chameleons: Diagnostic challenges","volume":"11","author":"Candelaresi","year":"2023","journal-title":"Eur J Radiol Open"},{"key":"10.25259\/SNI_298_2026\/ref-2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1159\/000471929","article-title":"Are we overlooking stroke chameleons? A retrospective study on the delayed recognition of stroke patients","volume":"44","author":"Chompoopong","year":"2017","journal-title":"Cerebrovasc Dis"},{"key":"10.25259\/SNI_298_2026\/ref-3","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S1052-3057(96)80023-1","article-title":"Lesion site in unilateral stroke patients with dysphagia","volume":"6","author":"Daniels","year":"1996","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_298_2026\/ref-4","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.07.015","article-title":"Stroke chameleons","volume":"23","author":"Dupre","year":"2014","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_298_2026\/ref-5","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/S1474-4422(11)70069-2","article-title":"Atypical presentations of acute cerebrovascular syndromes","volume":"10","author":"Edlow","year":"2011","journal-title":"Lancet Neurol"},{"key":"10.25259\/SNI_298_2026\/ref-6","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1161\/STROKEAHA.115.011913","article-title":"Streamlined hyperacute magnetic resonance imaging protocol identifies tissue-type plasminogen activator-eligible stroke patients when clinical impression is stroke mimic","volume":"47","author":"Goyal","year":"2016","journal-title":"Stroke"},{"key":"10.25259\/SNI_298_2026\/ref-7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.neurad.2014.10.005","article-title":"Imaging of acute stroke: CT and\/or MRI","volume":"42","author":"L\u00f6vblad","year":"2015","journal-title":"J Neuroradiol"},{"key":"10.25259\/SNI_298_2026\/ref-8","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1111\/acem.13029","article-title":"Potentially missed diagnosis of ischemic stroke in the emergency department in the greater Cincinnati\/ Northern kentucky stroke study","volume":"23","author":"Madsen","year":"2016","journal-title":"Acad Emerg Med"},{"key":"10.25259\/SNI_298_2026\/ref-9","doi-asserted-by":"crossref","first-page":"E347","DOI":"10.1161\/CIR.0000000000001209","article-title":"2024 Heart disease and stroke statistics: A report of US and global data from the American Heart Association","volume":"149","author":"Martin","year":"2024","journal-title":"Circulation"},{"key":"10.25259\/SNI_298_2026\/ref-10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/WCO.0000000000000620","article-title":"Stroke mimics and chameleons","volume":"32","author":"Moulin","year":"2019","journal-title":"Curr Opin Neurol"},{"key":"10.25259\/SNI_298_2026\/ref-11","first-page":"669","article-title":"Advanced statistics: Missing data in clinical research--part 2: Multiple imputation","volume":"14","author":"Newgard","year":"2007","journal-title":"Acad Emerg Med"},{"key":"10.25259\/SNI_298_2026\/ref-12","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1515\/dx-2013-0038","article-title":"Missed diagnosis of stroke in the emergency department: A cross-sectional analysis of a large population-based sample","volume":"1","author":"Newman-Toker","year":"2014","journal-title":"Diagnosis (Berl)"},{"key":"10.25259\/SNI_298_2026\/ref-13","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.pjnns.2016.04.009","article-title":"Comprehensive imaging of stroke-looking for the gold standard","volume":"50","author":"Piliszek","year":"2016","journal-title":"Neurol Neurochir Pol"},{"key":"10.25259\/SNI_298_2026\/ref-14","first-page":"14","article-title":"Sample size calculation in medical studies","volume":"6","author":"Pourhoseingholi","year":"2013","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"10.25259\/SNI_298_2026\/ref-15","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s40463-018-0305-8","article-title":"Usage of the HINTS exam and neuroimaging in the assessment of peripheral vertigo in the emergency department","volume":"47","author":"Quimby","year":"2018","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"10.25259\/SNI_298_2026\/ref-16","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1212\/WNL.0000000000001830","article-title":"Acute stroke chameleons in a university hospital: Risk factors, circumstances, and outcomes","volume":"85","author":"Richoz","year":"2015","journal-title":"Neurology"},{"key":"10.25259\/SNI_298_2026\/ref-17","doi-asserted-by":"crossref","first-page":"e75615","DOI":"10.1371\/journal.pone.0075615","article-title":"Reliability of visual assessment of non-contrast CT, CT angiography source images and CT perfusion in patients with suspected ischemic stroke","volume":"8","author":"Van Seeters","year":"2013","journal-title":"PLoS One"},{"key":"10.25259\/SNI_298_2026\/ref-18","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s40141-014-0061-2","article-title":"Dysphagia management in acute and sub-acute stroke","volume":"2","author":"Vose","year":"2014","journal-title":"Curr Phys Med Rehabil Rep"},{"key":"10.25259\/SNI_298_2026\/ref-19","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.ncl.2021.02.001","article-title":"Emergency care of patients with acute ischemic stroke","volume":"39","author":"Zubair","year":"2021","journal-title":"Neurol Clin"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/prevalence-of-chameleons-in-patients-with-ischemic-stroke-a-cross-sectional-study\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/prevalence-of-chameleons-in-patients-with-ischemic-stroke-a-cross-sectional-study\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:20:27Z","timestamp":1782465627000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/prevalence-of-chameleons-in-patients-with-ischemic-stroke-a-cross-sectional-study\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":19,"alternative-id":["10.25259\/SNI_298_2026"],"URL":"https:\/\/doi.org\/10.25259\/sni_298_2026","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"article-number":"374"}}