Diagnosis of Stroke
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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 ]]>MRI]]> or a ]]>CT scan]]> .
The diagnosis evaluation includes:
- Neurological exams
- Blood and urine tests
- Imaging scans
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
- ]]>Magnetic resonance angiography]]> (MRA)—a test that uses a dye to show the blood vessels in the brain
- 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
- ]]>Doppler ultrasound]]> 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:
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.
Stroke diagnosis. The Internet Stroke Center website. Available at: http://www.strokecenter.org/patients/diagnosis/tests.htm. Accessed February 10, 2010.
Stroke National Institute of Neurological Disorders and Stroke website. Available at: http://stroke.nih.gov.
Last reviewed February 2010 by ]]> J. Thomas Megerian, MD, PhD, FAAP]]>
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 medical condition.
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