Adult Critical Care Specialty (ACCS) Practice Exam

Which diagnostic test is most appropriate for identifying an acute cerebral infarction in a patient admitted with a possible CVA?

1. Ultrasound

2. CT Scan

3. MRI

4. Cerebral angiography

The correct answer is: CT Scan

The CT scan is the most appropriate diagnostic test for identifying an acute cerebral infarction, particularly in the context of a patient presenting with symptoms of a possible cerebrovascular accident (CVA). When a patient is suspected of having a stroke, time is of the essence as rapid intervention can improve outcomes. CT scans are widely available and can be performed quickly, making them the first-line imaging modality in acute stroke settings. They are especially useful within the first few hours of symptom onset, helping to differentiate between ischemic strokes (acute cerebral infarction) and hemorrhagic strokes (bleeding). In the case of an ischemic stroke, the scan may appear normal in the very early stages, but it is capable of identifying later changes that suggest infarction or rule out other causes of neurological deficits. While MRI is more sensitive for detecting early ischemic changes and can provide additional details about cerebral tissue, it is not typically used as the initial diagnostic test due to its longer acquisition time, limited availability, and higher cost. Other imaging modalities, such as ultrasound, primarily assess blood flow in major vessels and are not as effective for direct visualization of brain tissue integrity in the acute setting. Cerebral angiography is used for evaluating blood vessels but is more invasive and