Other Diagnostic Tests

• A CTscan of the head will reveal an area of hyperintensity (white) identifying that a hemorrhage has occurred. The CTscan will either be normal or hypointense (dark) in an area where an infarction has occurred. It may take 24 hours (and rarely longer) to reveal the area of infarction on a CTscan.

• MRI of the head will reveal areas of ischemia earlier and with better resolution than a CTscan. Diffusion-weighted imaging can reveal an evolving infarct within minutes.

• Carotid Doppler studies will determine whether the patient has a high degree of stenosis in the carotid arteries supplying blood to the brain (extracranial disease).

• The ECG will determine whether the patient has atrial fibrillation, which is a major risk factor for stroke.

• A transthoracic echocardiogram will identify whether there are heart valve abnormalities or problems with wall motion resulting in emboli to the brain.

Short-term treatment goals for hemorrhagic stroke include rapid neurointensive care treatment to maintain adequate oxygenation, breathing, and circulation. Management of increased ICP and blood pressure (BP) are important in the acute setting. Long-term management includes prevention of complications and prevention of a recurrent bleed and delayed cerebral ischemia.

Prevention of long-term disability and death related to the stroke are important regardless of stroke type.

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