Stroke testing is necessary to ensure appropriate treatment is offered. It may include an exam, CT scan, blood tests, electrocardiogram, and angiogram.
When someone is suspected of having a stroke, they’re treated in the emergency room. Time is of the essence; the earlier appropriate treatment is initiated, the better the patient’s chances for recovering lost function. However, before starting treatment, the medical team must determine what type of stroke you’re having, and rule out other problems that can cause similar symptoms (such as a brain tumor).
Some of the tests used to diagnose a stroke are:
• Medical history and physical exam
• CT scan and/or MRI
• Blood tests
• Ultrasound tests, including an echocardiogram and carotid ultrasound
Your examination for stroke will begin with your doctor taking a history and physical exam. Your doctor will ask detailed questions about your symptoms and when they started, as well as what medications you’re taking, any recent head injuries, any other medical conditions you have, and other factors. Your doctor will check the strength and sensation in various parts of your body, look into your eyes, listen to your heart and the arteries in your neck, and perform any other necessary parts of the physical examination.
You will usually have a CT scan next. This is a series of X-rays; you are moved slowly through a donut-shaped scanner for the test. In some cases, your doctor may also ask for an MRI; for this test, you will be in a small tube within a large scanner for a period of time. The results of these imaging studies can help your doctor determine whether you have had a stroke, and if so, what type of stroke it is.
Blood tests are also useful in diagnosing a stroke. This can help your doctor determine whether you may have abnormal blood sugar, an infection, changes in your electrolytes (the minerals in your blood), or other problems that may be causing your symptoms.
In many cases, the evaluation of a possible stroke includes an electrocardiogram, in which electrodes are placed on your chest to check the electrical rhythm of your heart. Certain types of abnormal heart rhythms may cause the formation of blood clots within the heart, which may then travel up to the brain and cause a stroke.
An echocardiogram, which is an ultrasound of your heart, may also be used as part of the evaluation of stroke. This can help your doctor determine if you have heart problems, and may be able to locate a source of clots that can cause strokes. In some cases, your doctor may also want an ultrasound test of your carotid arteries, the arteries in the front of your neck. Prevention of future strokes may involve treating problems with your heart or your arteries.
An angiogram is a test in which dye is injected into blood vessels, to make the arteries visible under X-ray imaging. This can allow your doctors to visualize blood flow through a part of your body. Your doctor may inject the dye into one of the arteries in your neck, to visualize the blood flow through your brain, allowing for precise determination of where your stroke occurred. To get the dye into the artery, a long flexible tube is inserted through a small incision in your groin area, and then moved up into the correct arteries.
Centers for Disease Control and Prevention (CDC). “Stroke: Types of Stroke.” CDC website (2014). http://www.cdc.gov/stroke/types_of_stroke.htm
National Institute of Neurological Disorders and Stroke (NINDS). “NINDS Stroke Information Page.” NINDS website (2015). http://www.ninds.nih.gov/disorders/stroke/stroke.htm
Mayo Clinic Staff. “Stroke: Diagnosis.” Mayo Clinic website (2015). http://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/diagnosis/dxc-20117291