Triage first — most suspected strokes are emergent
Any patient with an active focal neurologic deficit, an altered level of consciousness, or symptoms within the typical acute treatment window needs immediate emergency department evaluation. The outpatient workflow below begins only after that triage call has been made and the acute pathway has been completed or excluded.
TIA with resolved symptoms
When a patient presents with neurologic symptoms that have fully resolved and the acute interval has passed but a TIA is suspected, urgent outpatient MRI of the brain (with diffusion-weighted imaging) is highly sensitive for small acute ischaemic lesions that change risk stratification and management. Coordinate with the patient's neurologist or primary care physician so vascular imaging and antithrombotic decisions are made in parallel.
Outpatient follow-up after known stroke
MRI brain is the preferred modality for post-stroke surveillance, characterisation of the infarct, and evaluation of new or evolving symptoms. Contrast is added when secondary causes (tumour, infection, demyelination) are being considered or when the original aetiology was incompletely characterised.
When MRI cannot be used
For patients with non-MRI-conditional implants or severe claustrophobia that has failed open-bore accommodation, non-contrast head CT can be used to evaluate established infarct and rule out haemorrhage, while acknowledging its limited sensitivity for early or small ischaemic lesions. Vascular imaging modalities outside our offered scope should be coordinated with a vascular specialist.
Ordering with Precise
Brain MRI is available across the network with neuroradiology sub-specialty reads. Mark the order STAT when a suspected TIA requires urgent next-day imaging; STAT targets a ≤ 2-hour read with critical findings phoned to the ordering provider.
Questions referring offices ask first.
Can I order outpatient imaging for a patient with active stroke symptoms?
No. Active neurologic deficits belong in the emergency department, not in an outpatient imaging queue.
Do I need contrast for outpatient MRI brain after stroke?
Usually not. Add contrast when an alternative diagnosis (tumour, infection, demyelination) is being considered.
Educational reference for referring providers. Not a substitute for clinical judgement or the current official appropriateness criteria. References imaging modalities offered by Precise; modalities not in our network are out of scope.