In hospital-to-hospital transfers for stroke, when should a repeat CT be performed?

• A. Immediately on arrival
• B. After 15 minutes
• C. Only if symptoms worsen
• D. More than 60 minutes since last CT

Answer: (D)

The key idea here is the timing of a repeat CT during a hospital-to-hospital stroke transfer. Re-imaging too soon often doesn’t reveal new information and can slow care, while waiting long enough allows any evolution, such as delayed hemorrhagic transformation or edema, to become detectable and influence management.

A repeat CT is best performed if more than 60 minutes have passed since the last CT. After that interval, imaging is more likely to show clinically relevant changes that could change treatment decisions or safety considerations for transfer.

Immediate re-imaging on arrival tends to duplicate the initial study and can delay the transfer process. Checking again after a brief 15-minute window is usually unnecessary for most stable patients, as significant CT changes are unlikely to appear so quickly. Re-imaging only when symptoms worsen focuses on acute deterioration, but the stated timing guideline targets a standard window that balances getting useful information with avoiding unnecessary delays during transfer.