For code stroke patients, what is the key reason to obtain a non-contrast CT head before thrombolysis?

For code stroke patients, what is the key reason to obtain a non-contrast CT head before thrombolysis?

• A. To exclude intracranial hemorrhage
• B. To measure brain edema
• C. To assess perfusion
• D. It is not needed

Answer: (A)

In acute stroke care, the first priority before giving thrombolysis is safety: you must rule out a hemorrhage. A non-contrast CT head is the fastest test to detect intracranial bleeding. If a bleed is present, thrombolysis would worsen it, so treatment is withheld. While CT may not pick up all early ischemic changes, it reliably excludes hemorrhage, which is the key contraindication to thrombolysis. Other imaging aspects like edema or perfusion can be informative in other scenarios, but the immediate decision hinges on ruling out a bleed.

In acute stroke care, the first priority before giving thrombolysis is safety: you must rule out a hemorrhage. A non-contrast CT head is the fastest test to detect intracranial bleeding. If a bleed is present, thrombolysis would worsen it, so treatment is withheld. While CT may not pick up all early ischemic changes, it reliably excludes hemorrhage, which is the key contraindication to thrombolysis. Other imaging aspects like edema or perfusion can be informative in other scenarios, but the immediate decision hinges on ruling out a bleed.