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Stroke Imaging in Primary Care: A Practical Guide for Family Physicians

Teaser: 

D'Arcy Little MD CCFP FCFP FRCPC,

Medical Director, Journal of Current Clinical Care and www.healthplexus.net, Adjunct Clinical Lecturer, Departments of Medical Imaging and Family Medicine, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract:
Stroke remains a leading cause of mortality and long-term disability, with optimal outcomes dependent on rapid recognition and timely intervention. Family physicians play a crucial role in the acute stroke care pathway, from initial assessment to long-term secondary prevention. Understanding contemporary stroke imaging protocols, recognizing early signs of cerebrovascular events, and knowing when to initiate urgent referral can significantly impact patient outcomes. This review provides family physicians with practical guidance on stroke imaging principles, current best practices, and clinical decision-making frameworks to optimize care for patients with suspected acute stroke.

Key Words: stroke, imaging, cerebrovascular events, patient outcomes, acute stroke.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Pre-test CME Quiz Post-test CME Quiz
Rapid Referral Over Time Windows—Modern stroke care extends treatment windows up to 24 hours with imaging guidance. Family physicians should refer ALL suspected stroke patients immediately, regardless of time from onset.
Recognition and Referral, Not Diagnosis—Primary care role is rapid recognition using simple tools (facial droop, arm weakness, speech difficulties) and immediate transport coordination—not comprehensive evaluation or imaging interpretation.
CT Excludes Hemorrhage, Doesn’t Confirm Stroke—Non-contrast CT’s main purpose is excluding bleeding, not confirming ischemic stroke. Normal CT should never delay referral for suspected stroke.
Advanced Imaging Guides Treatment—Multimodal imaging (CT + angiography + perfusion) identifies large vessel occlusions for thrombectomy and estimates salvageable brain tissue for individualized treatment decisions.
Time Windows Don’t Exclude Patients—Advanced imaging can identify treatment candidates many hours after traditional windows—don’t use time to exclude patients from specialist evaluation.
Watch for Subtle Posterior Strokes—Isolated dizziness/vertigo in older patients may be posterior circulation stroke, especially with coordination or visual symptoms.
Check Blood Glucose Only—Correct abnormal glucose before referral—hypoglycemia mimics stroke and hyperglycemia worsens outcomes. Skip other tests to prioritize speed.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Radiology, stroke
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A Prescription for Pluralism in a Polarized Time

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFP, DipSportMed CASEM, FCFP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D

is a comprehensive family doctor working in Manotick, Ontario, Board Director of the College of Family Physicians of Canada, Chair of the General Assembly at Ontario Medical Association and Director for Longitudinal Leadership Curriculum at the University of Ottawa Undergraduate Medical Education. Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Past Chair Section of General and Family Practice Ontario Medical Association, Bruyere Foundation

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Abstract: This article explores the growing impact of polarization on healthcare, emphasizing the importance of pluralism—respectful coexistence of differing views—in clinical practice. It argues that empathy, humility, and open dialogue are essential for maintaining trust, improving patient care, and supporting a healthier society. Medicine must embrace both scientific evidence and social understanding to heal divisions.
Key Words: pluralism, healthcare trust, polarization, empathetic communication.
Healthcare Depends on Pluralism, Not Ideology—Effective medical care requires respect for diverse beliefs. Physicians must treat all patients equally—regardless of political or personal views—because the focus should be on care, not conformity.
Polarization Is Undermining Trust—Increasing division in society is seeping into healthcare. Patients and professionals alike are affected by ideological tensions that erode trust, silence open dialogue, and make care delivery more difficult.
Pluralism Demands Empathy and Dialogue—Pluralism isn’t about agreeing on everything. It’s about the ability to disagree with respect, stay in conversation, and prioritize human connection over ideological alignment.
The Cure Lies in Everyday Interactions—The path forward starts with small choices: how we speak to patients, how we listen to colleagues, and how we create space for questions and concerns without judgment. Empathy, humility, and honest engagement are essential for healing divisions.
Create Space for Questions Without Judgment—Encourage patients to voice concerns or skepticism—especially around sensitive topics like vaccines, mental health, or gender care—by responding with curiosity rather than correction. This fosters trust and opens the door to meaningful, evidence-based conversation.
Practice Cultural and Ideological Humility—Recognize that patients’ beliefs may shape their health decisions. Rather than challenging those beliefs directly, seek to understand their context and tailor communication accordingly. This improves rapport and enhances care outcomes across diverse populations.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Sports Medicine, pluralism, healthcare trust, polarization, empathetic communication
Disclaimer: 
Disclaimer at the end of each page