Projects & Grants

Internal Grant Competition DGC
START-UP grant

The importance of multimodal CT examination in stroke mimics diagnosis
Project IdNU23-04-00336
Main solverprof. MUDr. Pavel Eliáš, CSc.
Period5/2023 - 12/2026
ProviderAgentura zdravotnického výzkumu ČR
AnotationStroke mimics (SM) present a variety of neurological disorders that exhibit symptoms similar to those of a proven cerebrovascular accident, despite not being a true stroke. Exclusion of ischaemic stroke and early detection of SM is crucial for reducing the number of unindicated intravenous thrombolysis treatments, which is the first choice of treatment for patients with stroke. Pre-hospital and hospital stratification is required for the differential diagnosis of SM. The current recommendations are based on the recognition of stroke and SM in the ambulance using structured assessment scales. The ambulance crew then further consults the diagnosis of suspected stroke with a neurologist in a stroke centre and based on this teleconsultation, the patient is transported to the nearest Primary Stroke Centre or Comprehensive Stroke Centre. Subsequent examination by a neurologist in a hospital, in conjunction with laboratory findings, are important in the differential diagnosis of an acute neurological deficit. Non-contrast head CT, and head and neck CT angiography, that are commonly used for the detection of large vessel occlusion, remain the gold standard in neuroimaging diagnostics in the case of suspected stroke. CT perfusion (CTP) may play an important role in the diagnosis of SM, but it is currently not a standard part of the stroke diagnostic procedures. Normal values of Tmax on CTP or abnormal values, where their location does not correspond with the clinical picture, may indicate stroke mimics. The project is a multicentre prospective observational clinical research focused on refining diagnostics in pre-hospital and hospital care. The main aim is to accurately identify SM in order to minimise the risk of receiving inappropriate treatment. It will also examine saved costs in the case of nonadministration of unindicated treatment and it will compare the number of complications related to the administration of unindicated treatment in patients diagnosed with SM.