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
Answer:
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