Template:Stroke workup: Difference between revisions
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===[[Stroke (main)|Stroke]] Work-Up=== | ===[[Stroke (main)|Stroke]] Work-Up=== | ||
*[[Head CT]] (non-contrast) | *[[Head CT]] (non-contrast) | ||
**In | **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 acute ICH the sensitivity is 95-100%<ref>Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med. 2006; 354(4):387–396.</ref> | **In acute ICH the sensitivity is 95-100%<ref>Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med. 2006; 354(4):387–396.</ref> | ||
**The goal of CTH is to identify stroke mimics (ICH, mass lesions, etc .)<ref>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.</ref> | |||
*[[MRI Brain]] DWI and cervical vascular imaging predict short-term risk for stroke in patients presenting with suspected TIA<ref name="ACEP">ACEP Clinical Policy: Suspected Transient Ischemic Attack[https://www.acep.org/Physician-Resources/Policies/Clinical-policies/Clinical-Policy-Suspected-Transient-Ischemic-Attack/ full text]</ref>. When feasible, physicians should obtain: | |||
**MRI with DWI/MRA in patients with high short-term risk for stroke (ACEP Level B Recommendation) | |||
**Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B Recommendation) | |||
*Labs | *Labs | ||
**POC glucose | **POC glucose | ||
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**UA (if infection suspected) | **UA (if infection suspected) | ||
**Utox (if ingestion suspected) | **Utox (if ingestion suspected) | ||
Revision as of 04:31, 16 August 2016
Stroke Work-Up
- 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 Recommendation)
- Carotid US/CTA/MRA in patients with high short-term risk for stroke (ACEP Level B Recommendation)
- Labs
- POC glucose
- CBC
- Chemistry
- Coags
- Troponin
- T&S
- ECG
- 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