Part 2: Ischemic Stroke: Evaluation, Treatment, and Prevention

Matthew Brandon Maas, MD, and Joseph E. Safdieh, MD

Dr. Maas is a fellow in Stroke and Neurocritical Care, Harvard Medical School, Departments of Neurology, Massachusetts General and Brigham and Women’s Hospitals, Boston, MA. Dr. Safdieh is an assistant professor of neurology, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY.

Question 10

The patient reports no significant past medical history. He is physically active and works out at a gym twice a week. On review of systems, the patient notes that he has had a moderate intensity, constant left-sided headache for the last 48 hours. He believes the headache is due to a neck strain because his right neck has been aching since he lifted weights the day the headache started. On examination, the left pupil is larger than the right pupil, and the left palpebral fissure is wider than the right.
Which of the following tests will most likely to lead to a diagnosis of the etiology of this patient’s TIAs?

  •  CT angiography of the neck
  •  Magnetic resonance angiography (MRA) of the head
  •  MRI of the brain
  •  Transesophageal echocardiogram

Updated 12/03/2014 • jdw | Copyright ©2018 Turner White Communications