Case 1: What scan?

Clinical History

HPI: 49 yo woman presents with left hemiplegia which began 1 hour prior to admission.

Questions

1. What is your clinical differential diagnosis?

Answer

2. What scan would you order next?

• A non contrast head CT is the initial study of choice in evaluating a patient presenting with a stroke.
• The head CT is used to assess for the presence of hemorrhage, which will appear white/hyperdense on CT.
• Contrast is not needed to assess for the presence of hemorrhage.
• One can also look for subtle changes of early infarction (cytotoxic edema); however, it often will take at least 4-6 hours for these changes to manifest on a CT.

View Images