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So, could someone explain the order of imaging/type of imaging that you use when locating a lesion in a patient? It was explained to me a couple times on rotation, but there it was a lot (with CT noncon, MRI T2, flare/DWI,... dark/bright...) and I got lost near the beginning.
Say a 50 year old patient who came in with a sudden onset left sided weakness, what order of tests would you look at?
Also, a more specific question, why can't you use CT contrast to look for the location of a stroke? (I know people say that because of the contrast you can't distinguish between ischemic vs. hemorrhage, but I don't get that. If it's ischemic, wouldn't it not enhance anyways, since there's no perfusion there, meaning no blood, and thus no contrast and would look just the same as a noncon; while if it's hemorrhagic, well you would see enhancement...?) Can someone be so kind as to explain this to me?
Say a 50 year old patient who came in with a sudden onset left sided weakness, what order of tests would you look at?
Also, a more specific question, why can't you use CT contrast to look for the location of a stroke? (I know people say that because of the contrast you can't distinguish between ischemic vs. hemorrhage, but I don't get that. If it's ischemic, wouldn't it not enhance anyways, since there's no perfusion there, meaning no blood, and thus no contrast and would look just the same as a noncon; while if it's hemorrhagic, well you would see enhancement...?) Can someone be so kind as to explain this to me?
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