Difference between revisions of "Template:Stroke - choice of investigation"
Jump to navigation
Jump to search
(→Choice of modality: and no contraindication) |
(Linked) |
||
| Line 3: | Line 3: | ||
*'''[[MRI of the head in stroke]]''' is generally less available, but preferred if your clinic has established procedures for its performance in acute stroke, and there are no MRI contraindications | *'''[[MRI of the head in stroke]]''' is generally less available, but preferred if your clinic has established procedures for its performance in acute stroke, and there are no MRI contraindications | ||
| + | {{Further|CT vs MRI in stroke}} | ||
===How soon=== | ===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}}</ref> | 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}}</ref> | ||
Revision as of 21:52, 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 in stroke is generally less available, but preferred if your clinic has established procedures for its performance in acute stroke, and there are no MRI contraindications
- Further information: CT vs MRI in stroke
How soon
According to UK guidelines, imaging should be performed immediately for people with suspected acute stroke if any of the following apply:[2]
- Indications for thrombolysis or early anticoagulation treatment
- Current anticoagulant treatment
- Any known bleeding tendency
- Depressed level of consciousness of Glasgow coma scale (GCS) of less than 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 2.2 . Acute stroke. UK National Institute for Health and Care Excellence (NICE). Last updated: 18 December 2018}}
