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Diagnosis of Stroke
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:
If the type of stroke can be identified within 4½ 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. (These time windows will change as more research is done.)
Tests to determine the cause, location, and amount of damage include:
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.
Carpenter, C, Keim S, Milne W, Meurer W, Barsan W. Thrombolytic therapy for acute ischemic stroke beyond three hours. J Emerg Med . 2010; June 23rd [Epub ahead of print].
Neuroimaging for acute stroke. EBSCO Publishing DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated August 30, 2012. Accessed September 4, 2012.
Stroke (acute management). EBSCO Publishing DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated August 30, 2012. Accessed September 4, 2012.
Stroke diagnosis. The Internet Stroke Center website. Available at: http://www.strokec... . Accessed September 4, 2012.
Know stroke. Stroke National Institute of Neurological Disorders and Stroke website. Available at: http://stroke.nih.gov . Accessed September 4, 2012.
Last reviewed October 2012 by Rimas Lukas, MD
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