According to the U.S. Centers for Disease Control and Prevention, Americans suffer nearly 800,000 strokes a year, and on average, one American dies from stroke every four minutes. The best chance that a victim has a surviving a stroke is fast treatment.  Health care experts note that when stroke victims get help within four and a half hours of the first signs of stroke it can save lives and reverse disabling symptoms.  

That means getting the people in and around your community to recognize the signs of a stroke and act right away to get help. That includes emergency room physicians.

According to a new study from researchers at Johns Hopkins University, ER doctors may be up to 30 percent more likely to overlook signs of stroke in women and minorities, and even more likely to miss the signs when the patient is under 45.

"Younger people are less likely to have a stroke, but when they have that stroke, they're much more likely to be missed," says Dr. David Newman-Toker, the study's lead author and a neurologist at John Hopkins.

Newman-Toker and his team looked over discharge records and emergency room visits of nearly 200,000 stroke patients in more than 1,000 hospitals from the period 2008-2009.  They found that nearly 13 percent of people admitted to the hospital with a stroke diagnosis had visited the emergency room up to 30 days earlier with complaints of headaches and dizziness - symptoms which could indicate a minor stroke or may act as the precursor to a more severe episode. But on this first ER visit, these patients were either diagnosed with minor conditions such as migraines or an ear infection or were sent home with no diagnosis at all. Almost a quarter of these patients returned within two days in the midst of an obvious stroke.

The study's authors weren't sure why these misdiagnoses seemed to happen more often with women, minorities, and younger patients.  Language barriers could play a factor.  As could the fact that many women don't present the classic signs of stroke such as garbled speech or weakness on one side of the body.  And younger patients may simply not fit the classic profile of a stroke patient.  

To be sure, not every patient who comes into the ER complaining of a headache is having a stroke.  But the study does show that the correlation between the initial mild symptoms and subsequent stroke is too strong to be a coincidence. Newman-Toker and his colleagues note that the consideration of a stroke diagnosis should no longer be limited to certain demographics and risk factors, especially when research shows that early treatment could help people of all ages, genders, and ethnicities to recover more quickly.

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