Awoman brings her husband to the emergency department and states that he is having a stroke. you are the student np on the hospitalist service and are sent down first to obtain the history and physical. you develop a differential diagnosis and know that the initial gold standard radiology test to further evaluate is:

The patient should be immediately examined through imaging of brain within the first three hours of the onset of symptoms. Different techniques can be used for brain imaging but some that are initial gold standard radiology tests are  Head CT without contrast and Brain MRI.

The patient should be examined through both tests because the specifications of the tests are different but both can help to detect stroke accurately.

1)Head computerized Tomography (CT) without contrast:

This CT test is sensitive for hemorrhagic and ischemic stroke. It Gives 100 % accurate results if performed in less than 3 hours after onset of symptoms. The sensitivity is around 86%–90% if performed during initial 6 hours and 93% if performed in 48 hours of the initiation of symptoms.

2)Brain MRI

This CT test is sensitive for hemorrhagic and ischemic stroke. No MRI studies have been carried out in first 3 hours of the onset of symptoms. The sensitivity is around 86%–90% if performed during initial 6 hours and 46 % if performed in 48 hours of the initiation of symptoms.

Note: Sensitivity of 86 % to 90% is considered as gold standard for the detection of strokes.

Hope it helps! :)

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