A 77-year-old male is brought into the emergency department accompanied by his daughter. She reports that her father has been complaining of right-handed weakness for 2 to 3 hours and that she has noticed him slurring his speech. On physical examination, the right hand grip strength is 1/5 compared to the left hand grip of 5/5. A facial droop is noted on the right side of the face. Cranial nerve dysfunction is noted in the right-sided cranial nerves VII, V, IX, X, XI, and XII. The clinician should request the following diagnostic test immediately:

Question

Quizplus · Accepted Answer

The patient's symptoms of right-handed weakness, slurred speech, and cranial nerve dysfunction suggest an acute stroke, which is a medical emergency. A computed tomography (CT) scan of the head is the most appropriate initial diagnostic test to differentiate between an ischemic stroke and a hemorrhagic stroke, as it can quickly identify hemorrhages, which is crucial for determining the appropriate treatment plan. Magnetic resonance imaging (MRI) may be used later for further evaluation, but it is not the first choice in an acute setting due to longer acquisition times. Lumbar puncture and electrocardiogram are not indicated based on the presented symptoms and the need for immediate stroke identification.

A 77-Year-Old Male Is Brought into the Emergency Department Accompanied