Analysis of misdiagnosis causes of acute cerebral infarction and preventive measures

XIANG Zhitao; CHEN Yangkun; ZHOU Baoyu

doi:10.3969/j.issn.1002-3429.2026.06.001

Abstract：Objective To analyze the causes of misdiagnosis related to acute cerebral infarction(ACI)and to investigate preventive measures to reduce such misdiagnoses.Methods A retrospective analysis was conducted on the clinical data of 2 patients with ACI-related misdiagnosis admitted from May 2024 to February 2025.Results A 22-year-old female patient presented with disturbance of consciousness and limb convulsions.Initially,the diagnosis was considered to be poisoning or infection,and corresponding treatments were given but with poor effect.Subsequently,after comprehensive vascular assessment,a diagnosis of left vertebral artery dissection with secondary basilar artery occlusion was confirmed.The misdiagnosis lasted 15 h.After diagnosis,endovascular treatment was performed,and the blood vessels were successfully recanalized,but the prognosis was poor.An 82-year-old male patient presented with stroke-like symptoms.Initially,he was diagnosed with ischemic stroke and underwent whole-brain angiography.Subsequently,it was confirmed as a brain abscess through multimodal magnetic resonance imaging.The misdiagnosis period was 3 d.After diagnosis,he was treated with anti-infection therapy and the condition stabilized.The follow-up prognosis was good.Conclusion The misdiagnosis related to ACI involves two aspects:missed diagnosis of true cerebral infarction and misjudgment of stroke mimics.Enhancing the diagnostic vigilance of medical staff,optimizing the identification of imaging signs,and standardizing the diagnosis and treatment process are important measures to reduce the misdiagnosis rate of this disease.