Template:Stroke workup: Difference between revisions
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**T&S | **T&S | ||
*[[ECG]] | *[[ECG]] | ||
**In large ICH or stroke, may see deep TWI and prolong QT, occ ST changes | |||
*[[Head CT]] (non-contrast) | *[[Head CT]] (non-contrast) | ||
**In ischemia stroke CT has sensitivity 42%, specificity 91%<ref>Mullins ME, Schaefer PW, Sorensen AG, Halpern EF, Ay H, He J, Koroshetz WJ, Gonzalez RG. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology. 2002 Aug;224(2):353-60.</ref> | **In ischemia stroke CT has sensitivity 42%, specificity 91%<ref>Mullins ME, Schaefer PW, Sorensen AG, Halpern EF, Ay H, He J, Koroshetz WJ, Gonzalez RG. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology. 2002 Aug;224(2):353-60.</ref> | ||
Revision as of 05:13, 2 September 2016
Stroke Work-Up
- Labs
- POC glucose
- CBC
- Chemistry
- Coags
- Troponin
- T&S
- ECG
- In large ICH or stroke, may see deep TWI and prolong QT, occ ST changes
- Head CT (non-contrast)
- MRI Brain DWI and cervical vascular imaging predict short-term risk for stroke in patients presenting with suspected TIA[4]. When feasible, physicians should obtain:
- MRI with DWI/MRA in patients with high short-term risk for stroke (ACEP Level B)
- Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B)
- Carotid US is slightly less sensitive than MRA, but useful for carotid stenosis eval[5] (ACEP Level C)
- Also consider:
- Pregnancy test
- CXR (if infection suspected)
- UA (if infection suspected)
- Utox (if ingestion suspected)
- ↑ Mullins ME, Schaefer PW, Sorensen AG, Halpern EF, Ay H, He J, Koroshetz WJ, Gonzalez RG. CT and conventional and diffusion-weighted MR imaging in acute stroke: study in 691 patients at presentation to the emergency department. Radiology. 2002 Aug;224(2):353-60.
- ↑ Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med. 2006; 354(4):387–396.
- ↑ Douglas VC, Johnston CM, Elkins J, et al. Head computed tomography findings predict short-term stroke risk after transient ischemic attack. Stroke. 2003;34:2894-2899.
- ↑ ACEP Clinical Policy: Suspected Transient Ischemic Attackfull text
- ↑ Nederkoorn PJ, Mali WP, Eikelboom BC, et al. Preoperative diagnosis of carotid artery stenosis. Accuracy of noninvasive testing. Stroke. 2002;33:2003-2008.