Stroke Diagnosis Tests

Submitted by Thiruvelan on Wed, 06/23/2010

If you had a stroke, or warning signs of stroke, it is very important to get prompt medical attention.
Step needed after a Stroke.

You need to consult doctor if

  • The stroke symptoms disappear without treatment
  • The stroke cause symptoms are important even if it goes without a treatment
  • Don’t try to diagnose by yourself

Your doctor or health care provider asks many questions to evaluate and diagnose the stroke cause:

  • Symptoms you had during a stroke
  • Your medical history – problems, operation and any other illnesses
  • Any illness, which run in your family
  • Medicines currently you are taking.
  • Doctor might be interested to talk to the person, who was with you during a stroke.

Stroke Diagnosis by Physical examination

During physical examination for stroke diagnosis,

your doctor will check.

  • pulse
  • blood pressure,
  • Examine heart, lungs, etc.

Neurologic examination for stroke diagnosis

It includes tests for muscles and nerves; your doctor will check muscles

  • Strength,
  • Sensation (or sensitivity),
  • Coordination or balancing
  • Reflexes

Additionally, test for stroke diagnosis

Ask a question to check

  • Memory,
  • Speech
  • Thinking ability

Stroke diagnosis tests

Depending on the results of your evaluation, your doctor may need additional tests to understand your problem; they are:

  • CT scans
  • MRI scans
  • Carotid Doppler
  • Transcranial Doppler
  • Magnetic resonance angiogram
  • Cerebral arteriogram

CT scans - CT scan utilizes x-rays to produce a 3D image of your head. CT scan can be helpful in diagnose of ischemic stroke, hemorrhagic stroke, and other problems of the brain and brainstem.

MRI scans - Magnetic resonance imaging (MRI) uses magnetic fields to produce a 3D image of your head. The MRI scan produces the images of the brain and spinal cord in more detail than CT scan to do. MRI can be helpful in diagnose of ischemic stroke, hemorrhagic stroke, and other problems involving the spinal cord, brain and brainstem.

Tests that View the Blood Vessels that Supply the Brain

Carotid Doppler - Carotid Doppler’s other names are Carotid duplex, Carotid ultrasound. High frequency non-hearable audio waves (ultrasound waves) are useful to show a picture of the carotid arteries in your neck, and the blood flowing to your brain. This test can be helpful to diagnose if your carotid artery is narrowing by arteriosclerosis (cholesterol deposition).

Transcranial Doppler (TCD) - Ultrasound waves are useful to measure blood flow in some of the arteries in your brain.

Magnetic resonance angiogram (MRA) - This is a special type of MRI scan, which can be helpful to see the blood vessels in your neck or brain.

Cerebral arteriogram - Cerebral arteriogram other names are cerebral angiogram, Digital subtraction angiography, or simple DSA. Inserting a catheter (a tiny, flexible tube) into an artery in your arm or leg and injecting a special dye (sensitive to x-ray) into the blood vessels leading to the brain. The x-ray images show any abnormalities of the blood vessels, which can include narrowing, blockage, or malformations. Cerebral arteriogram is a more complicated test than carotid doppler or MRA, but its results are the most accurate.

Other Neurologic Tests

Electroencephalogram (EEG) HeHH - EEG measures your brain waves through several electrical leads painlessly attached to your head. EEG is not routinely in use for stroke diagnosis, but your doctor may order once he/she thinks that you may have had a seizure.

Lumbar puncture (LP, spinal tap) - Insert a needle in your lower back to obtain a sample of the fluid (cerebrospinal fluid, CSF) which surrounds your brain and spinal cord. LP is not routinely in use for diagnosis of ischemic stroke. However, LP is often required if sub-arachnoid hemorrhage (bleeding from a cerebral aneurysm) is suspected. You may need LP if your doctor suspects a nervous system infection (such as meningitis) or inflammation.

Electromyogram / Nerve conduction test (EMG / NCV) - This test records the electrical activity of the nerves and muscles. EMG is not useful for stroke diagnosis, but you may need if your doctor suspects a problem with the nerves in your arms or legs.

Brain’s biopsy - Surgical diagnosis tests perform by removing a small piece of the brain for microscopic examination. Biopsy is useful to diagnose lesions (tumors) which are not able to diagnose by CT or MRI scans. It is very rarely useful for stroke diagnosis, when your doctor suspects cerebral vasculitis.