Emergency Medicine Cases

Ep 209 Nondisabling Stroke Recognition and Management

43 snips
Nov 11, 2025
Dr. Walter Himmel, an emergency medicine physician and stroke expert, teams up with Dr. Katie Lin, a stroke neurologist and educator. They dive deep into the complexities of non-disabling strokes, emphasizing that they still pose serious risks. Key topics include identifying stroke mimics, understanding the nuances of antiplatelet therapies, and the critical importance of timely imaging. They also discuss the management of young patients and the significance of careful risk stratification to prevent future strokes.
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INSIGHT

Defining Non-Disabling Stroke

  • Non-disabling strokes allow patients to remain independent despite mild deficits like facial droop or mild weakness.
  • Assessment must consider patient-specific function (e.g., a pianist's mild hand weakness may be disabling).
INSIGHT

Don't Dismiss Stroke In Young Adults

  • Approximately 10–15% of strokes occur in people under 50, so age alone shouldn't exclude stroke.
  • Young strokes include atherosclerosis, dissections, PFO, sickle cell, and congenital causes and must be considered.
ANECDOTE

Bee Sting Caused Reversible Stroke

  • Anton shares a hiking bee-sting case where anaphylaxis caused transient arm weakness that reversed with epinephrine.
  • Anaphylaxis-induced cerebral vasospasm can mimic ischemic stroke and needs prompt epinephrine.
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