Post-Stroke Recrudescence: A Case Report and Literature Review

Post-stroke recrudescence (PSR) is a clinical entity characterized by the acute transient recurrence of previously recovered focal stroke deficits. Various names have been used to describe PSR, which further complicates its diagnosis. Increased awareness of this condition is crucial for preventing inappropriate management and unnecessary testing. Mechanisms proposed for PSR include altered drug response in diseased brain areas and immune activation due to a compromised blood-brain barrier (BBB). Patients with PSR have a distinct vascular risk profile and fewer cardiovascular complications than those with transient ischemic attacks (TIAs). Accurate differentiation of PSR from other conditions that mimic stroke is essential for its appropriate management. Misdiagnosis may lead to unnecessary procedures and prolonged hospitalization. This article presents the case of a 56-year-old female with multiple episodes of PSR that were initially misdiagnosed in the emergency department. The patient had a history of hypertension and ischemic stroke, and her episodes of PSR were often triggered by elevated blood pressure. Future studies should focus on developing validated prediction scores to guide recurrent stroke workup. Enhancing awareness and understanding of PSR can optimize resource allocation and improve patient outcomes.