A Narrative Review on Stroke Mimics and Chameleons: Revisiting and Unveiling the Disguise

Stroke refers to a neurological deficit that has an acute onset and a vascular origin. The classical signs and symptoms of a stroke include facial drooping, weakness, and disturbances in talking or speech. Sometimes, these symptoms may also arise from conditions that do not involve a cerebrovascular event, leading to a misdiagnosis of stroke, known as “stroke mimics.” Another interesting category is the “stroke chameleon,” which refers to a class of stroke that occurs in the absence of the typical characteristics suggestive of stroke and instead presents with atypical features that can lead to a false negative diagnosis. A thorough history taking, with an emphasis on the onset of symptoms, is crucial because features of stroke are always acute in onset. Prompt neuroimaging is ultimately necessary to prevent misdiagnosis and to provide emergent thrombolysis within the life-saving window period. In this review, we discuss the various possible stroke mimics and chameleons that have been reported and are available across the web.