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CT Scan of the Brain and Mini-Strokes

Dear Dr. Dave and Dr. Dee,

I had to visit the local emergency room the other night when a good portion of the left side of my face went numb along with a little swelling around the temple and eye socket. After having a CT scan, I was given my release with a description of temporal tingling.

However, the day after the episode, I received a call from the ER Director telling me to call my family physician to talk with the neuroradiologist and with my regular neurologist (I have had Parkinson's since 1990 and am now 39)regarding an unrelated problem that showed on the CT scan rework. Then the physician says that it may be something, but might not be anything to worry about. Although there may be evidence of several mini-strokes on Friday, there was nothing else on the CT scan to worry about.

I talked with my neuro this morning and he said to start with one aspirin a day. He will schedule an MRI scan asap and let me know what else we will do when he can get some answers. What does all this mean to you from a distance?


Who's on first

Dear Who's on first,

Sounds like you are getting proper medical attention. It's not unusual to go to an emergency department in the after hours, have a test done such as a CT of the brain, and then be notified the next day that a radiology subspecialist, such as the neuroradiologist has reviewed your films and picked up a subtle finding.

The emergency department did a callback to you to get your doctors talking to the neuroradiologist. The end result was that your regular neurologist, having all the info, started you on aspirin and ordered an MRI, which should provide a much clearer picture.

Evidence of ischemic strokes (common stroke due to blockage of a blood vessel) tend not to show up well on noncontrast CT scan until 24-48 hours after the stroke. Whereas hemorrhagic strokes (stroke due to a ruptured blood vessel in the brain) usually show up immediately on noncontrast CT scan. Sometimes evidence of old mini-strokes shows up on CT scans, but may or may not be related to the problem underinvestigation. Mini-strokes may occur at some point in the past and go unrecognized by the patient. Sounds like your doctors are on the ball. Hope that helps. Good luck.