Functional Stroke Mimics: Patient Characteristics, CT ‐Based Multimodal Imaging and Long‐Term Outcome in a Comparative Cohort Study

BACKGROUND AND PURPOSE: Functional stroke-like episodes (FSMs) are an increasingly recognised stroke mimic with demographic and clinical characteristics that differ from acute ischaemic strokes (AISs) but have unclear long-term outcomes. MATERIALS AND METHODS: We report retrospective data on consecutive patients with FSM who underwent acute perfusion-CT (PCT) admitted to Lausanne University Hospital (2003-2017). We compared them to all contemporaneous AISs undergoing PCT from the Acute-STroke-Registry-and-Analysis-of-Lausanne (ASTRAL). RESULTS: 0.04). After a median of 9 years follow-up, FSM patients failed to functionally improve further and 55% experienced additional functional neurological events. CONCLUSION: In this single-centre cohort of consecutive FSMs undergoing acute PCT, we identified distinctive demographic and clinical features, normal CT-based neuroimaging, but still a high thrombolysis rate. Long-term observation revealed a high rate of recurrent functional events and persistent disability, suggesting the need for more effective treatment and regular follow-up.