Diagnosing Stroke

The diagnosis of a stroke is usually made without much difficulty. Many healthcare providers work together to gather information from the patient, family members or other caregivers. A comprehensive examination, including a detailed neurological evaluation (testing functions of the nervous system), is performed. This will involve testing nerves and reflexes. An electrocardiogram, or EKG, and other forms of heart monitoring can provide evidence of heart problems that may have contributed to the stroke. Blood and urine testing is usually performed. Doctors often order a CT scan (computed axial tomography) or a MRI scan (magnetic resonance imaging) to get a detailed picture of the brain. An ultrasound can help determine if there is narrowing in the arteries that supply blood to the brain.

The main arteries supplying the head with blood are known as the carotid arteries and run up the neck to the brain. Sometimes more invasive evaluation tests are needed to confirm the cause of the stroke. This could include a cerebral angiogram in which dye is injected into arteries supplying blood to the brain. This outlines the arteries and helps reveal any blockages or areas of narrowing.

Doctors typically order blood tests for patients with stroke in order to search for evidence of inflammation in the blood that could predispose to stroke. Some patients have “sticky factors” in their blood that predispose to clotting. These abnormalities can be detected and treated.