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Stroke

Can a CT scan show evidence of TIAs

03/05/2008

Question:

When we arrived to take care of my 90 year-old uncle, he was lying on the floor. Because he is obese, it took a while to get him up. His vision was impaired to the point that he saw only light (no images.) He was slurring his words and confused. We took him to the hospital, and the next two days his left eye was drooping prominently. He was in the hospital for 3-1/2 days, but never diagnosed with a possible stroke, TIA, or anything. His diagnosis read "fall, confusion." On questioning his neurologist, I was told that the CT scan performed there would not indicate whether he had a TIA or otherwise. He had had similar symptoms on several other occasions over the past few months, though not as severe. (confusion, slurring words.) Does this not sound as though he had a stroke, and is a CT scan instrumental in determining such?

Answer:

Less likely, he suffered a stroke. However, MRI is the best imaging technique to exclude a stroke for certainty. TIA will not show on either MRI or CT scan. It is a good idea to check his BP first while lying down then while standing. If his BP goes significantly down when standing then this could explain the recurrent confusion. In this case, the BP medications dosage must be modified. Other etiologies fir these episodes include infection (Urinary tract infection etc...) or seizure. At any rate, his neurologist should be able to determine the cause of these episodes.

Best Regards.

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Response by:

Yousef  Mohammad, MD, MSc Yousef Mohammad, MD, MSc
Assistant Professor
Director, Stroke Fellowship Program
College of Medicine
The Ohio State University