Difference between revisions of "Template:Stroke - choice of investigation"
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(Created page with "===Choice of modality=== *'''CT of the head in stroke''' is generally the first investigation because of high availability.<ref name=Radiologyassistant-stroke>{{cite web|u...") |
(→Choice of modality: +How soon) |
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===Choice of modality=== | ===Choice of modality=== | ||
*'''[[CT of the head in stroke]]''' is generally the first investigation because of high availability.<ref name=Radiologyassistant-stroke>{{cite web|url=http://www.radiologyassistant.nl/en/p483910a4b6f14/brain-ischemia-imaging-in-acute-stroke.html|title=Brain Ischemia - Imaging in Acute Stroke|website=Radiology Assistant|author=Majda Thurnher}} Published: June 2008</ref> It detects about 60% of infarcts in the first 3 to 6 hours, and almost always thereafter.<ref name=Radiologyassistant-stroke/> | *'''[[CT of the head in stroke]]''' is generally the first investigation because of high availability.<ref name=Radiologyassistant-stroke>{{cite web|url=http://www.radiologyassistant.nl/en/p483910a4b6f14/brain-ischemia-imaging-in-acute-stroke.html|title=Brain Ischemia - Imaging in Acute Stroke|website=Radiology Assistant|author=Majda Thurnher}} Published: June 2008</ref> It detects about 60% of infarcts in the first 3 to 6 hours, and almost always thereafter.<ref name=Radiologyassistant-stroke/> | ||
| − | *MRI of the head is more sensitive, but less available<noinclude> | + | *MRI of the head is more sensitive, but less available |
| + | |||
| + | ===How soon=== | ||
| + | According to UK guidelines, imaging should be performed immediately for people with suspected acute stroke if any of the following apply:<ref name=nice>{{cite web|url=https://pathways.nice.org.uk/pathways/stroke/acute-stroke.pdf|title=Acute stroke|website=UK National Institute for Health and Care Excellence (NICE)}} Last updated: 18 December 2018}} | ||
| + | *Indications for thrombolysis or early anticoagulation treatment | ||
| + | *Current anticoagulant treatment | ||
| + | *Any known bleeding tendency | ||
| + | *Depressed level of consciousness (GCS <13) | ||
| + | *Unexplained progressive or fluctuating symptoms | ||
| + | *Papilledema, neck stiffness or fever | ||
| + | *Severe headache at onset of stroke symptoms. | ||
| + | |||
| + | "Immediately" is defined as 'ideally the next slot and definitely within 1 hour.<ref name=nice/> | ||
| + | |||
| + | In case of acute stroke without indications for immediate imaging, it should be performed within a maximum | ||
| + | of 24 hours after onset of symptoms.<ref name=nice/><noinclude> | ||
==References== | ==References== | ||
{{reflist}} | {{reflist}} | ||
</noinclude> | </noinclude> | ||
Revision as of 18:31, 24 December 2018
Choice of modality
- CT of the head in stroke is generally the first investigation because of high availability.[1] It detects about 60% of infarcts in the first 3 to 6 hours, and almost always thereafter.[1]
- MRI of the head is more sensitive, but less available
How soon
According to UK guidelines, imaging should be performed immediately for people with suspected acute stroke if any of the following apply:<ref name=nice>. Acute stroke. UK National Institute for Health and Care Excellence (NICE). Last updated: 18 December 2018}}
- Indications for thrombolysis or early anticoagulation treatment
- Current anticoagulant treatment
- Any known bleeding tendency
- Depressed level of consciousness (GCS <13)
- Unexplained progressive or fluctuating symptoms
- Papilledema, neck stiffness or fever
- Severe headache at onset of stroke symptoms.
"Immediately" is defined as 'ideally the next slot and definitely within 1 hour.[2]
In case of acute stroke without indications for immediate imaging, it should be performed within a maximum of 24 hours after onset of symptoms.[2]
References
- ↑ 1.0 1.1 Majda Thurnher. Brain Ischemia - Imaging in Acute Stroke. Radiology Assistant. Published: June 2008
- ↑ 2.0 2.1 Cite error: Invalid
<ref>tag; no text was provided for refs namednice
