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A Normal Head CT Scan Does Not "Rule Out" Ischemic Stroke - Part I - The Stroke Blog
“Head CT ruled out stroke.” It happens multiple times each week. A patient arrives for a consultation, bringing outside medical records from the emergency department where his or her initial evaluation took place. Inevitably I will find the above statement, or some slight variation of it, stated in the notes, as if serving as a justification for why it was okay to send the patient home. Often the patient wonders why he developed partial visual loss for 30 minutes, or why the left side of her body was tingling for hours even prior to the decision to seek medical attention. After all, the symptoms seemed real at the time, but how to explain what happened since the head CT ruled out a stroke? From my own experience caring for young stroke patients, I hear the same themes reiterated: “Everyone tells me that I don’t look like I’ve had a stroke, but I have never felt like the same person since my stroke.” “I have so much difficulty focusing and concentrating since my stroke, and I’m worried about my short term memory.” “I was told that I shouldn’t still be experiencing pain now that my vertebral artery dissection has healed, but my headaches …