Stroke

Preliminary Diagnosis: Stroke

I. What imaging technique is first-line for this diagnosis

• Non-contrast CT of the brain.

II. Describe the advantages and disadvantages of this technique for diagnosis of stroke.

Advantages

• Relatively fast, inexpensive imaging modality.

• Highly specific and sensitive to evaluate and rule out intracranial hemorrhage.

Disadvantages

• Exposes patients to ionizing radiation.

• Less sensitive for detecting ischemia or infarction compared with MR imaging.

III. What are the contraindications for the first-line imaging technique?

• CT imaging may be contraindicated in pregnant patients.

IV. What alternative imaging techniques are available?

• Non-contrast MR of the brain (Stroke Protocol)

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of stroke.

Non-contrast MR of the brain (Stroke Protocol)

Advantages

• Imaging is more sensitive and specific in detecting early signs of ischemia and infarction.

• Better able to distinguish chronicity of infarct than CT

• Does not expose the patient to ionizing radiation.

• Sensitive in detecting subtle microhemorrhage.

Disadvantages

• Expensive

• Time-consuming

• Requires significant patient cooperation to minimize artifact

VI. What are the contraindications for the alternative imaging techniques?

Non-contrast MR of the brain (Stroke Protocol)

• Contraindicated in patients with non-MR compatible hardware.