Initial treatment if ischemic stroke is suspected
What are the initial steps if ischemic stroke is suspected?
Head CT rules out hemorrhage, subdural hematoma, and tumor. It is the first and most important test when evaluating for thrombolysis.
In cases of suspected stroke, page the service responsible for rapidly addressing stroke (stroke team)—every minute counts.
Immediately check blood glucose because hypoglycemia or hyperglycemia can cause focal neurologic deficits mimicking stroke.
Also obtain an electrocardiogram (ECG) and a troponin test, as initial cardiac workup can reveal atrial fibrillation or myocardial infarction.
Coagulation studies, basic chemistries, and complete blood count should be drawn, but thrombolysis should not be delayed while awaiting these results unless there is reason to suspect that they would be abnormal.