Bedside eye examination can warn of stroke
September 19th, 2009 - 12:38 pm ICT by IANS ( Leave a comment )Washington, Sep 19 (IANS) A simple, one-minute eye movement examination by the bedside by doctors works better than MRI to identify impending stroke in patients complaining of dizziness and nausea.
These findings are based on a study of 101 patients, who were already at higher than normal risk of stroke because of factors including high blood pressure or high cholesterol.
The project, spearheaded by a Johns Hopkins neurologist with colleagues at the University of Illinois (U-I), Peoria, found that the quick, extremely low-cost exam caught more strokes than the current gold standard of MRI.
This possibility suggests that if further research on broader populations confirms these results, physicians may have a way to improve care and avoid the high costs of MRI in some cases.
“The idea that a bedside exam could outperform a modern neuroimaging test such as MRI is something that most people had given up for dead, but we’ve shown it’s possible,” says David E. Newman-Toker, assistant professor of neurology at the Johns Hopkins School of Medicine.
Dizziness is a common medical problem, Newman-Toker says, responsible for 2.6 million emergency room visits annually in the US, says a Johns Hopkins School release.
While most dizziness complaints are caused by benign inner-ear balance problems, about four percent are signals of stroke or transient ischemic attack (TIA, a condition that often warns of impending stroke in the coming days or weeks).
Because more than half of patients with dizziness who are experiencing strokes show none of the classic stroke symptoms - one-sided weakness, numbness, or speech problems - emergency room physicians are estimated to misdiagnose at least a third of them, losing the chance for quick and effective treatment.
“When patients having a stroke are sent home erroneously, consequences can be really serious, including death or permanent disability,” says Jorge C. Kattah, chairman of neurology at U-I’s St. Francis Medical Centre, who co-led the study.
These findings were published online in Stroke.
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Tags: dizziness and nausea, emergency room physicians, emergency room visits, eye examination, eye movement, gold standard, high blood pressure, high cholesterol, inner ear balance problems, johns hopkins school, johns hopkins school of medicine, medical problem, neuroimaging, neurologist, numbness, school of medicine, sided weakness, speech problems, stroke symptoms, transient ischemic attack