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Tests For Stroke
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If someone has a suspected stroke and goes to A&E, does an emergency MRI or CT take place to confirm it?
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Should do, if the scan shows evidence of a clot then this would be treated with so called clot busters, if the cause is a bleed then this treatment would be dangerous. Time is of the essence if you suspect someone has or is having a stroke the sooner the treatment can be given the more effective it will be .
They probably rush to do the tests if they're reasonably confident that the person has had a stroke but are more likely to take their time if they don't really consider it to be a possibility.
As a vague sort of analogy, I remember that a teaching colleague of mine felt rather faint during a staff meeting (which was in an incredibly hot and stuffy room, so nobody was really surprised). She went outside with a friend and passed out. As the guy in charge of first aid I attended but, just as I was considering putting her in the recovery position, she came round. She insisted upon driving home although a colleague shadowed her on the journey.
The following morning she came into school as normal but passed out again. This time we insisted that she was checked out at A&E. As you can imagine, they didn't regard it as an emergency, so she had to wait ages before they gave her a blood test. However as soon as they saw the result she was rushed into the intensive care unit because they realised that she'd had two heart attacks!
So (understandably) A&E staff have to make decisions every day about whether to rush into lots of tests or to simply wait a while.
As a vague sort of analogy, I remember that a teaching colleague of mine felt rather faint during a staff meeting (which was in an incredibly hot and stuffy room, so nobody was really surprised). She went outside with a friend and passed out. As the guy in charge of first aid I attended but, just as I was considering putting her in the recovery position, she came round. She insisted upon driving home although a colleague shadowed her on the journey.
The following morning she came into school as normal but passed out again. This time we insisted that she was checked out at A&E. As you can imagine, they didn't regard it as an emergency, so she had to wait ages before they gave her a blood test. However as soon as they saw the result she was rushed into the intensive care unit because they realised that she'd had two heart attacks!
So (understandably) A&E staff have to make decisions every day about whether to rush into lots of tests or to simply wait a while.
Hi 237SJ - I wasn't with him as I thought he was being a drama queen and it was the middle of the night (kids in bed, no-one to watch them, etc). His case was unusual as he phoned the ambulance himself so he was quite 'with it'. The doctor wanted to send him home but the nurse insisted on the scan. He left here at 1.30 am (ish) and I had a phone call at 7.00 am to say he was being rushed to Birmingham for emergency brain surgery. I expect a lot depends upon other factors. Hope whoever you are worried about is ok.
Thanks. It`s my mum. She has metastic breast cancer and her behaviour is changing. Yesterday the Oncologist arranged a CT scan to see what`s happening but I don`t know if the behaviour changes - confusion, slurred speech, frailty is caused by cancer in the brain in which case we have to wait for the scan appointment which might be weeks away, or a stroke which means that maybe there is something else going on. Or senility brought on by the stress etc. The whole situation is so bloody awful and I have to go off to work tomorrow (not back until Sunday) and leave her. I have told her I will look in on my way to work and see how she is and if she has any more worrying symptoms, I`m taking her to hospital. Thing is, if the symptoms are caused by cancer, then that`s not a case for A&E. I`ve been on the phone to a friend of mine who is a very experienced nurse and she said she needs a scan soon. Getting one isn`t simple though.
Thanks NOM. She has requested one but I don`t know how soon it is going to come through. Yesterday the Oncolgist told me that when ladies have had breast cancer for a long time (usually where it has settled in the bones for a few years) the brain is the place that it goes. The thing is, these symptoms came about fairly quickly and I`m not sure the cancer would have had an effect that quickly if it had gone to the brain.
Not at the moment. She has been given steroids to perk her up and give her an appetite. Whatever`s happening is definitely a brain event but there are so many complicating factors that it`s hard to ascertain what it happening and that is the problem. GPs don`t work with Oncologists who don`t work with A&E etc.
237.
I know this is hard for you, but one get's to the point of "what is the point of more and more investigations, what do they achieve and what else can be done?"
We know that we are dealing with an 80+ year old lady with metastatic breast cancer with secondaries in the bone and brain, treated with the conventional method of treatment.
If her recent symptoms are due to cerebral metastasis........nothing more can be done, as she has had steroids to lessen the pressure on her brain.
Just because she has cerebral metastasis doesn't exclude her form a stroke, which may be due to a bleed (unlikely), a clot (equally unlikely) or a thrombus ( possibly). But even so, what treatment is going to be effective and prolong her life?
I cannot see the point of a CT or MRI, but that will be decided upon by the clinicians.
I am sorry that I have to post in these terms.
I know this is hard for you, but one get's to the point of "what is the point of more and more investigations, what do they achieve and what else can be done?"
We know that we are dealing with an 80+ year old lady with metastatic breast cancer with secondaries in the bone and brain, treated with the conventional method of treatment.
If her recent symptoms are due to cerebral metastasis........nothing more can be done, as she has had steroids to lessen the pressure on her brain.
Just because she has cerebral metastasis doesn't exclude her form a stroke, which may be due to a bleed (unlikely), a clot (equally unlikely) or a thrombus ( possibly). But even so, what treatment is going to be effective and prolong her life?
I cannot see the point of a CT or MRI, but that will be decided upon by the clinicians.
I am sorry that I have to post in these terms.
Sqad - the steroids are to increase her apetite because she`s not eating (not for pressure in the brain). They don`t know yet if there is anything in her brain which is why they want a CT. The slurred speech etc came on suddenly after she had a strange event where she thought she had slept the night in my house and had a shower there (she hadn`t - she was in her own house). The situation was compounded by the fact that for the first time ever, she had taken a herbal sleeping pill which contained passiflora which has been linked to confusion and hallucinations. So we thought it was that. Now we realise that it wasn`t. Anyway, since typing this she has phoned and the Oncology Ct scan has come through for tomorrow.
So would I. Although cancer is likely, I think there could be a chance that she had a stroke (I know she has had high cholesterol and refused to take statins). We did get some good news that what they thought was a liver met was in fact a fatty liver cycst but then this about the brain was the next worry. One thing I have learned about this disease is to expect the unexpected. I was fretting that I had been negligent in not taking her to A&E but at least with this rushed appointment, that issue is solved. At least I can go off to work feeling a little less worried.
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