A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg.
What is your appropriate initial management for this patient?
A- Schedule another appointment whenever she has symptoms
B- Schedule transesophageal echocardiography
C- Schedule carotid duplex ultrasonography
D- Schedule MRI to the brain
E- Obtain CT scan of the head
Any case of suspected stroke should be evaluated instantly with CT scan. This case is most likely to be stenosis of carotid and needs carotid duplex but this is a later step. The question asks for initial step and it should be a CT scan as it is available now in urgent care facilities.
The correct answer is E