Preliminary Diagnosis: Stroke
I. What imaging technique is first-line for this diagnosis
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Non-contrast CT of the brain.
II. Describe the advantages and disadvantages of this technique for diagnosis of stroke.
Advantages
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Relatively fast, inexpensive imaging modality.
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Highly specific and sensitive to evaluate and rule out intracranial hemorrhage.
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Disadvantages
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Exposes patients to ionizing radiation.
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Less sensitive for detecting ischemia or infarction compared with MR imaging.
III. What are the contraindications for the first-line imaging technique?
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CT imaging may be contraindicated in pregnant patients.
IV. What alternative imaging techniques are available?
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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
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Imaging is more sensitive and specific in detecting early signs of ischemia and infarction.
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Better able to distinguish chronicity of infarct than CT
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Does not expose the patient to ionizing radiation.
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Sensitive in detecting subtle microhemorrhage.
Disadvantages
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Expensive
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Time-consuming
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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)
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Contraindicated in patients with non-MR compatible hardware.
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