Stroke diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on [[History and Physical examination|clinical presentation]], [[CT scan]], [[MRI]] findings, | There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on [[History and Physical examination|clinical presentation]], [[CT scan]], [[MRI]] findings. | ||
== Diagnostic Study of Choice == | |||
=== Study of choice === | |||
There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on [[History and Physical examination|clinical presentation]], [[CT scan]], [[MRI]] findings. | |||
*Non-contrast CT scan is fast, widely-available and inexpensive. It can rule in hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) with over 95% accuracy. CT scan also has the ability to rule in massive ischemic stroke in two third of cases, but is is not sensitive for minor ischemic stroke. | |||
*MRI is the most sensitive and specific test for diagnosing ischemic stroke, specially minor ischemic stroke with limited deficits, and may help detect presence of infarction in few minutes of onset of symptoms.<ref name="pmid26243819">{{cite journal |vauthors=Musuka TD, Wilton SB, Traboulsi M, Hill MD |title=Diagnosis and management of acute ischemic stroke: speed is critical |journal=CMAJ |volume=187 |issue=12 |pages=887–93 |date=September 2015 |pmid=26243819 |pmc=4562827 |doi=10.1503/cmaj.140355 |url=}}</ref><ref name="pmid16227545">{{cite journal |vauthors=Barber PA, Hill MD, Eliasziw M, Demchuk AM, Pexman JH, Hudon ME, Tomanek A, Frayne R, Buchan AM |title=Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging |journal=J Neurol Neurosurg Psychiatry |volume=76 |issue=11 |pages=1528–33 |date=November 2005 |pmid=16227545 |pmc=1739399 |doi=10.1136/jnnp.2004.059261 |url=}}</ref><ref name="pmid15494579">{{cite journal |vauthors=Kidwell CS, Chalela JA, Saver JL, Starkman S, Hill MD, Demchuk AM, Butman JA, Patronas N, Alger JR, Latour LL, Luby ML, Baird AE, Leary MC, Tremwel M, Ovbiagele B, Fredieu A, Suzuki S, Villablanca JP, Davis S, Dunn B, Todd JW, Ezzeddine MA, Haymore J, Lynch JK, Davis L, Warach S |title=Comparison of MRI and CT for detection of acute intracerebral hemorrhage |journal=JAMA |volume=292 |issue=15 |pages=1823–30 |date=October 2004 |pmid=15494579 |doi=10.1001/jama.292.15.1823 |url=}}</ref> | |||
===Sequence of Diagnostic studies=== | |||
*History and physical exam | |||
*Non-contrast CT scan | |||
*MRI | |||
Revision as of 23:46, 30 August 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maryam Hadipour, M.D.[2]
Overview
There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on clinical presentation, CT scan, MRI findings.
Diagnostic Study of Choice
Study of choice
There is no single diagnostic study of choice for the diagnosis of stroke. But stroke can be diagnosed based on clinical presentation, CT scan, MRI findings.
- Non-contrast CT scan is fast, widely-available and inexpensive. It can rule in hemorrhagic stroke (intracerebral or subarachnoid hemorrhage) with over 95% accuracy. CT scan also has the ability to rule in massive ischemic stroke in two third of cases, but is is not sensitive for minor ischemic stroke.
- MRI is the most sensitive and specific test for diagnosing ischemic stroke, specially minor ischemic stroke with limited deficits, and may help detect presence of infarction in few minutes of onset of symptoms.[1][2][3]
Sequence of Diagnostic studies
- History and physical exam
- Non-contrast CT scan
- MRI
- ↑ Musuka TD, Wilton SB, Traboulsi M, Hill MD (September 2015). "Diagnosis and management of acute ischemic stroke: speed is critical". CMAJ. 187 (12): 887–93. doi:10.1503/cmaj.140355. PMC 4562827. PMID 26243819.
- ↑ Barber PA, Hill MD, Eliasziw M, Demchuk AM, Pexman JH, Hudon ME, Tomanek A, Frayne R, Buchan AM (November 2005). "Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging". J Neurol Neurosurg Psychiatry. 76 (11): 1528–33. doi:10.1136/jnnp.2004.059261. PMC 1739399. PMID 16227545.
- ↑ Kidwell CS, Chalela JA, Saver JL, Starkman S, Hill MD, Demchuk AM, Butman JA, Patronas N, Alger JR, Latour LL, Luby ML, Baird AE, Leary MC, Tremwel M, Ovbiagele B, Fredieu A, Suzuki S, Villablanca JP, Davis S, Dunn B, Todd JW, Ezzeddine MA, Haymore J, Lynch JK, Davis L, Warach S (October 2004). "Comparison of MRI and CT for detection of acute intracerebral hemorrhage". JAMA. 292 (15): 1823–30. doi:10.1001/jama.292.15.1823. PMID 15494579.