A 67-year-old woman with hypertension presents with sudden onset of headache, vomiting, and left-sided weakness. On examination, she has weakness of the left face, hand, and leg (graded three out of five), blood pressure of 180/100 mm Hg, and respiration of 20/min. Which of the following is the most appropriate initial diagnostic test?
CT scan is still superior to MRI in certain circumstances, particularly in the emergency setting, for diagnosing acute subarachnoid hemorrhage, intracerebral bleeding, fractures of the face, temporal bone, and base of the skull. A CT is useful in evaluating patients with osseous spinal stenosis and spondylosis, but an MRI is preferred if there are neurologic defects.
CT scan with contrast
MR scan with gadolinium
CT scan without contrast
MR cerebral angiogram
C.N.S.