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Which is a true statement regarding a stroke protocol in the ER?

  1. A CT scan of the head is only done if a patient has a previous history of stroke

  2. An MRI is required to rule out stroke

  3. A CT scan of the head must be done as soon as possible

  4. An unenhanced CT scan of the head is sufficient

The correct answer is: A CT scan of the head must be done as soon as possible

A CT scan of the head must be done as soon as possible in the case of a suspected stroke because time is of the essence in stroke management. Rapid imaging is crucial to determine whether a stroke is ischemic (caused by a blockage) or hemorrhagic (caused by bleeding). This differentiation is essential because the treatment protocols differ significantly based on the type of stroke. Immediate CT imaging helps identify any hemorrhage or other acute intracranial processes that may be contributing to the patient's symptoms. Early identification allows for timely interventions, potentially improving patient outcomes and reducing morbidity and mortality associated with stroke. While other imaging modalities such as MRI can provide more detailed information, they are not the first-line imaging modality in acute settings due to longer acquisition times and the need for patient stabilization. Moreover, CT scans done quickly can also help rule out other conditions that mimic stroke symptoms, thus guiding appropriate treatment.