Prospective Italian Validation of SMS in Patients With Suspected Acute Stroke

Inclusion Criteria: * Age ≥ 18 years at the time of presentation to the Emergency Department. * Presentation to the Emergency Department with a clinical suspicion of acute stroke, identified at nursing triage and/or through activation of the stroke pathway. * Presentation to the Emergency Department during the 6-month prospective enrollment period. * Feasibility of real-time collection of the data required to calculate the Stroke Mimics Score (SMS), including: age, systolic blood pressure, presence/absence of seizure at onset, presence/absence of headache at onset, presence/absence of confusion at onset, presence/absence of syncope at onset, presence/absence of isolated sensory deficit, presence/absence of motor deficit, history of coronary artery disease, history of prior stroke or transient ischemic attack (TIA). * Availability of a final hospital discharge diagnosis at the end of hospitalization or Emergency Department observation. * Signed informed consent from the patient or caregiver. If the patient is unconscious upon arrival at the Emergency Department, deferred consent will be applied. Exclusion Criteria: * Age \< 18 years. * Inability to fully collect the data required to calculate the Stroke Mimics Score (SMS). * Absence of a clearly defined final hospital discharge diagnosis. * Voluntary discharge, transfer, or death before completion of the diagnostic workup, in the absence of a reliable diagnosis. * Repeated Emergency Department visits for the same clinical event (only the first visit will be considered).