You’re the Doctor

You’re the Doctor

Dr. Joseph P. Broderick, Director of the University of Cincinnati Gardner Neuroscience Institute, provides brain scans and gives you the chance to be the doctor!

  1. The two scans below show the head of the same patient, who suffered an acute stroke (image at left). Members of the Greater Cincinnati/Northern Kentucky Stroke Team reopened a blocked artery in the patient’s brain with t-PA, a clot-busting medicine (right). If the blocked artery can be opened quickly enough, the restoration of blood flow can salvage damaged brain tissue. If reopening occurs too late, brain tissue will die, even if blood flow is restored. In such situations, the patient will have a poorer recovery or may die.

Brain scans of stroke

Current national guidelines state that t-PA must be administered within how many hours after onset of stroke symptoms?

a)      8 hours

b)      6 hours

c)      4 ½ hours

d)      3 hours

e)      2 hours

(Answer at bottom of page)

 

  1. The two CT images show the head of the same patient, 41⁄2 hours apart. The patient came to the emergency department following a sudden onset of weakness on the left side and become much more poorly responsive during the 4 1/2 hours between scans.

Brain scan of stroke patient

What is the diagnosis?

 

a)   Large malignant brain tumor

b)   Large ischemic stroke (dead brain from not enough blood)

c)    Large area of encephalitis

d)   Large brain hemorrhage

Clue: The bone of the skull is the most dense and appears very white on a CT scan; brain tissue is less dense and appears gray; cerebrospinal fluid is the least dense and is dark. One other substance in the body is denser than brain tissue but not as dense as bone.

(Answer at bottom of page)

 

You’re the Doctor Answers

  1. 4½ hours. And the chance for an excellent outcome dramatically increases the earlier one can administer t-PA after symptoms first start.
  2. Large brain hemorrhage
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