In cases of suspected stroke, what imaging study is typically performed initially?

In the assessment of a suspected stroke, a Computed Tomography (CT) scan is typically the first imaging study performed. This choice is primarily due to the need for rapid evaluation in an emergency setting to differentiate between ischemic strokes and hemorrhagic strokes.

A CT scan is readily available in emergency departments and can be performed quickly, which is crucial when time is of the essence, as certain treatments for stroke are time-dependent. The speed at which a CT can provide imaging makes it an appropriate choice for initial assessment.

In cases of ischemic stroke, the CT scan can show subtle changes over time, but initially, it may appear normal. In contrast, if there is a hemorrhagic stroke, the CT will reveal blood outside of the blood vessels. This differentiation helps guide immediate treatment decisions, such as whether to administer thrombolytic therapy or initiate surgical intervention.

Other imaging options, like MRI, are highly sensitive but take longer to perform and are not always available in emergency situations. An X-ray of the chest does not evaluate brain integrity or blood flow within the brain tissues, thus it is not suitable for diagnosing strokes. Ultrasound of the carotid arteries is useful in assessing potential sources of emboli but is not typically first-line