Diagnosis of Stroke

The ability to determine the precise location of a stroke, the cause of the stroke and the amount of damage is essential for making treatment decisions. Physicians must quickly determine whether the stroke is ischemic or hemorrhagic before appropriate treatment can begin.

Physicians unanimously agree that not only are the following screening tools used most frequently to determine stroke risk, but also become diagnostic tools if a person is having a stroke:

Physical Examination A physician will conduct a physical exam in order to assess the overall status of the patient. The physician will listen to the patient's neck arteries in order to determine if there is a bruit. A bruit creates an audible swishing sound that a physician will hear with the aid of a stethoscope. A bruit indicates increased turbulence in the carotid arteries and is often caused by partial obstruction. Top
Basic Laboratory Tests Physicians may test for diabetes or examine the blood for an elevated level of homocysteine. Homocysteine is a sulfur-containing amino acid that when present in high amounts leads to an increased chance of stroke. However, homocysteine can be managed through treatments. Top
Computed Tomography (CT) Scan This diagnostic test is a special radiographic technique that uses a computer to generate multiple X-ray images of the brain. It reveals soft tissue structures not shown by conventional radiology. Computed tomography scans allow physicians to determine whether a patient has suffered an ischemic or hemorrhagic stroke. Top
Computed Tomographic Angiography (CTA) Computed tomographic angiography combines the use of X-rays and computerized images to visualize the blood flow in arterial and venous vessels throughout the body, especially in the neck and brain. Top
Magnetic Resonance Imaging (MRI) A special imaging technique that generates very clear pictures of soft tissues, the brain and the spinal cord. An MRI is particularly useful in exposing the damage done to brain tissue by an ischemic stroke. These scans are acutely precise in identifying the exact location of the stroke and the severity of the stroke. Top
Magnetic Resonance Angiography (MRA) A non-invasive method of vascular imaging and determination of internal anatomy without injection or exposure to radiation. This technique is used particularly for cerebral (head) arteries and veins and also generates information concerning collateral arteries. Top
Carotid Ultrasonography A useful diagnostic and screening tool that produces an ultrasound of the neck. Sound waves are utilized to illustrate possible blockages in the arteries of the neck. It can also measure the speed at which blood is flowing to the brain. Top
Transcranial Doppler (TCD) A small, hand-held device that uses sound waves to assess blood flow through the cerebral (head) vessels. It is a non-invasive, painless and safe test that can be administered at a patient's bedside. Top
PET Scanning A standard imaging and non-invasive tool used to show the status of brain tissue even if blood flow to the area is reduced. Top
Arteriography This procedure involves injecting a dye visible in X-rays to determine if the arteries are damaged. The X-rays alert physicians of possible irregularities of the blood vessels such as aneurysms. Top
Echocardiogram An Echocardiogram (ECG) is a test that uses high frequency sound waves to image the heart and its surrounding tissues. Many physicians use this test to reveal if a heart problem may contribute to a patient's susceptibility of experiencing a stroke. Top