Background: Stroke mimic is a major diagnostic challenge and may be difficult to distinguish from real strokes. The aim of this study was to evaluate the relative frequency of stroke mimics in patients with clinical signs of stroke.

Methods: In this cross sectional-study, the medical records of 1985 patients with stroke admitted to Poursina Hospital were enrolled using the census technique. Data collection tool was a checklist which include age, sex, imaging results (MRI and CT scan and primary and final diagnoses.

Results: Of the 1985 patients, 295 (14.9%) were identified with brain stroke mimics. The mean age in the group of patients with mimics and real stroke were 66.5±16.4 years and 72.4±9.6 years, respectively. The highest number of stroke belonged to 61-80 years in stroke groups (68.8%) and mimics (58.3%), respectively. There was a significant correlation between age and early diagnosis of stroke or stroke mimic (P<0.0001). The highest frequency of stroke mimics was related to brain tumors (10.5%), hypoglycemia (9.2%) and toxic poisoning (8.5%).

Conclusion: Due to the high number of stroke mimics, further attention is necessary to aid in differential diagnosis and clinical procedures in patients with stroke signs.