When you are experiencing the symptoms of a stroke, an emergency diagnosis must be made as quickly as possible. Time is critical in preventing further damage to your brain and in reversing the damage already done. For this reason, you should get to an emergency room as quickly as possible.
After an initial review of your symptoms and medical history, a physical exam will focus on identifying the area of your brain that is being damaged. Your condition will be stabilized. An intravenous (IV) line will be started; blood and urine tests will be collected; and you will most likely have an examination of your head by computerized imaging—either an
The diagnosis evaluation includes:
Blood and urine tests
If the type of stroke can be identified within three hours of the beginning of your symptoms, you may be treated with IV "clot-busting" drugs to prevent worsening and possibly restore blood flow to the involved areas of your brain. If it is within approximately six hours of the onset of your symptoms, you may be treated with intra-arterial (IA) “clot busting” drugs.
Tests to determine the cause, location, and amount of damage include:
CT scan—a type of x-ray that uses a computer to make pictures of structures inside the head
MRI scan—a test that uses magnetic waves to make pictures of structures inside the head
Arteriography—a test that shows arteries in the brain after an injection of x-ray dye
CT angiography (CTA)—a test that uses a dye to show blood vessels using the CT machine
Functional MRI—a test that shows brain activity by picking up signals from oxygenated blood in the brain
or carotid ultrasonography
—a test that shows narrowing of the carotid arteries and vertebral arteries in the neck that supply the brain
Electroencephalogram (EEG)—a test that uses sensors to evaluate electrical brain activity; may be helpful to rule out other causes of symptoms that may look like a stroke
Lumbar puncture—a sample of the cerebrospinal fluid from the lower back; not routinely done, unless the doctor is trying to rule out a hemorrhagic stroke or an infection of the central nervous system
Many strokes are due to heart problems, so be prepared to have heart function tests, as well. Possible tests include:
Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
Echocardiogram——a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
Albers GW, Amarenco P, Easton JD, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2008;133(suppl 6):887S-968S.
Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL.
Harrison's Principles of Internal Medicine.
16th ed. New York, NY: McGraw-Hill; 2004.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a