Review of Related Diseases (RRD) 10 – Disorders of the Neurological System Practice Test

Differentiating an ischemic from a hemorrhagic brain attack relies on imaging, not on symptoms alone. The sudden problems you see—weakness, trouble speaking, facial droop—can occur with either type, so you can’t rely on history or exam alone to tell them apart.

A quick non-contrast CT scan of the head is the first test because it rapidly shows whether there’s bleeding in the brain. If blood is present, that points to hemorrhagic stroke and changes the treatment plan away from clot-busting therapies. If the scan doesn’t show a bleed, the patient may be eligible for ischemic-stroke treatments, including thrombolysis or thrombectomy, depending on timing and other factors. MRI, especially diffusion-weighted imaging, can be more sensitive for detecting early ischemia when CT is inconclusive.

Other tests like a blood glucose check help manage the patient but don’t determine the stroke type, and EEG isn’t used to distinguish ischemic from hemorrhagic stroke.