Stroke

Diagnosis 

How well you recover from a stroke has a lot to do with how quickly your stroke is diagnosed and treatment begins. If you can get to a hospital within an hour of your first symptoms, you stand a better chance of being diagnosed and treated within the necessary three-hour window that can minimize the damage to your brain.

Evaluation by a stroke care team

When you first arrive at the hospital, emergency personnel, doctors, and other members of the stroke care team will perform and order the following tests to determine as quickly as possible if you’re having a stroke, and if you are, the type of stroke (ischemic or hemorrhagic) and the location of the problem:

• Medical information – You’ll be asked to describe your symptoms and provide a medical history, family history of illnesses, and a list of any medications that you take.
• Physical exam – Your doctor will examine you by listening to your heart and checking your pulse, lungs, blood pressure, muscles, nerves, sensation, coordination, reflexes, memory, speech, and thinking.
• Blood tests – Blood tests will be done to provide more information but also to rule out other possible causes of the stroke.
• Computed tomography (CT) or magnetic resonance imaging (MRI) – Most hospitals will give you a CT or MRI to determine if the stroke was caused by a blockage in the artery (ischemic stroke) or by bleeding (hemorrhagic stroke).
• Carotid ultrasound/transcranial Doppler, magnetic resonance angiogram (MRA), CT angiogram, or carotid angiogram – These tests may be performed to help your doctor see how blood is flowing through the carotid artery.
• Echocardiogram – Sometimes, a stroke can be related to a heart problem, so your doctor may also request an echocardiogram to find out for sure.

If the stroke is caused by the blockage or narrowing of the arteries to the brain, your doctor may also look at arteries in other parts of the body for signs of coronary artery disease (CAD) or peripheral artery disease (PAD). If arteries are narrowed or blocked in one part of the body, chances are good that plaque is building up in other parts of the body, too, putting you at risk for other problems, such as a heart attack.

Silent stroke diagnosis

A silent stroke has no symptoms, so the people who have them don’t know it until they have an MRI for some other reason. Just like transient ischemic attacks (TIAs) or “mini-strokes,” silent strokes are a warning that you may need treatment to avoid having another, potentially more damaging stroke.