You are here

Acute Stroke: Missed Diagnosis

Original Program Date: April 28, 2015
Estimated time: 1 hour
Release date: June 1, 2015
Expiration date: June 1, 2016

CME for this activity is available June 1, 2015 - June 1, 2016.

View Activity

This activity is jointly provided by Medical Education Resources and National Stroke Association.

Program Overview

A study by Newman-Toker et al released in 2014 focused on the incident rate of missed stroke diagnoses in the emergency room. The analysis found that 12.7% of stroke admissions may have been misdiagnosed and were subsequently readmitted with confirmed stroke diagnosis. Though this figure is likely an underestimate, since it only captures missed diagnoses followed by another adverse stroke event (leading to readmission), it corresponds to as many as 165,000 missed stroke diagnoses per year.

The numbers in this study imply that a significant portion of the stroke population actually makes it to the emergency room in the early stages of a stroke, yet are sent home without receiving stroke-related treatment. Dizziness is the most common symptom associated with missed stroke diagnosis, thus identifying it along with headache as a potential stroke symptom is critical.

Purpose Statement

Acute Stroke: Missed Diagnosis activity will educate learners on the diagnosis of acute stroke in the emergency room with patients who present with atypical symptoms.

Goals and Learning Objectives

The goal of the Acute Stroke: Missed Diagnosis activity is to educate healthcare professionals on atypical acute stroke presentation and the corresponding bedside tests for diagnosis.

Through participation in this activity, learners should be able to:

  • Discuss opportunity for early identification of stroke by EMS and ED triage nurse
  • Demonstrate awareness of trends in missed stroke diagnoses in the emergency room setting
  • Identify atypical stroke symptoms that should trigger assessment for stroke
  • Identify which bedside tests are effective at ruling out stroke
  • Develop a plan to integrate this knowledge into their clinical practice

Target Audience

The Acute Stroke: Missed Diagnosis activity is targeted at emergency medicine professionals, including physicians, nurses, physicians assistants, and nurse practitioners – the professionals who are frequently on the front line for triage of potential stroke patients. This activity is also appropriate for neurologists and other stroke specialists who may have the opportunity to educate peers within their facility.

Physician Credit

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Medical Education Resources (MER) and National Stroke Association. MER is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Medical Education Resources designates this activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Credit
Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This CE activity provides 1 contact hour of continuing nursing education.

Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299, for 1 contact hour.

For questions regarding this activity, please contact Medical Education Resources or National Stroke Association.


This activity is designed for individual participation and each individual must register for the event. For those seeking continuing education, post-test and evaluation forms must be completed in order to receive credit. These forms will be available to you immediately following your participation in the activity. All participants will also receive the required forms for completion within a week of their participation via email. It is the responsibility of the participant to return the completed forms to There are no fees for participation or receiving credit for this activity.

For those seeking continuing education credits, the following is required:

  1. Read the learning objectives and faculty disclosures.
  2. View the educational activity.
  3. After viewing the activity, complete the post-assessment evaluation. 
  4. Click on “Submit” to finishing the requirements to receive accreditiation for this activity. 

A statement of credit will be issued only upon receipt of a completed evaluation form and post-test with a score of 70% or better. Statements of credit will be issued within 6 weeks.

If you are viewing this program as a group, contact us at for more information.

Content Developed and Presented By
Edward C. Jauch, MD, MS, FAHA, FACEP
Professor and Director, Division of Emergency Medicine, Department of Medicine                          
Professor, Department of Neurosciences
Associate Vice Chair for Research, Department of Medicine
Medical University of South Carolina
Charleston, South Carolina

David S. Liebeskind, MD, FAAN, FAHA, FANA
Professor of Neurology 
Director, Neurovascular Imaging Research Core
Director, UCLA Vascular Neurology Residency Program
Associate Neurology Director, UCLA Stroke Center
Los Angeles, California

Disclosure of Conflict of Interest

Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all its educational activities. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a CE activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality CE activities that promote improvements or quality in health care and not the business interest of a commercial interest.

Faculty Disclosures

The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this CME activity:

Name of Faculty

Reported Financial Relationship

Edward C. Jauch, MD, MS, FAHA, FACEP

Research: Genentech, Inc. , Stryker, Covidien, Penumbra

David S. Liebeskind, MD, FAAN, FAHA, FANA

Research: NIH-NINDS Consulting: Stryker, Covidien

The content managers reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:

Name of Content Managers

Reported Financial Relationship

Michelle Murdock, National Stroke Association

No financial relationships to disclose

MER content managers

No financial relationships to disclose


The content and views presented in this educational activity are those of the speakers and do not necessarily reflect those of Medical Education Resources, National Stroke Association, and/or Genentech, Inc. The speakers have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.

MER’s Privacy Policy

The Acute Stroke: Missed Diagnosis activity is supported by an educational grant from Genentech, Inc.

Additional Resources

Find a Support Group


Get Involved


For over 30 years we have been the trusted source for free resources and education to the stroke community. Together, we empower survivors and their circle of care to thrive after stroke. Make your tax-deductible donation today to support the growing needs of the stroke community.