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Diagnosis of Stroke

A stroke is a medical emergency. If you think you are having one, call for emergency medical services right away .

A stroke can be diagnosed based on your signs, symptoms, and physical and neurological exams done when you get to the hospital. Your doctor may want to do other tests to find out the type of stroke you had, what part of the brain is affected, or if there is an underlying cause.

Tests to Evaluate Stroke and Effect of Stroke

Imaging Tests

Images can tell your doctor about places of bleeding, blockage, or where the problem is. These tests check the brain, blood vessels, and other structures.

Blood Tests

Blood tests can be used to check your platelet, glucose, electrolyte, and cholesterol levels. It can also check your blood clotting time. This can help diagnose or rule out a stroke. Some blood tests can also test how well your kidneys and liver are working.

Electrical Activity Tests

This can be tested with:

  • Electroencephalogram (EEG)—to measure electrical activity of the brain with electrodes placed on your head
  • Evoked response test—to measure how your brain handles sensory details

Other Tests

Your doctor may also test how well you swallow, how you react to food textures and tastes, and how you use language. Strokes can harm these parts of the brain. This will help guide the healing process.

A lumbar puncture may be done to check your cerebrospinal fluid (CSF). This fluid covers and protects the brain and spinal cord. It can be tested if your doctor thinks you may have an infection or a subarachnoid hemorrhage.

Tests of Your Heart

Many strokes are from heart disease. If your doctor thinks you have this, you may have more tests, such as:

  • Electrocardiogram (EKG)—To test the heart's electrical activity by measuring electrical currents through the heart muscle
  • Electrocardiogram —to find abnormalities in the heart muscle by highlighting places of poor blood flow
  • Holter monitor—to record your heart rhythm over 24 hours or more. It may be able to find any rhythm changes after a stroke.
REFERENCES:

Carpenter, C, Keim S, Milne W, et al. Thrombolytic therapy for acute ischemic stroke beyond three hours. J Emerg Med. 2011;40(1):82-92.

How is a stroke diagnosed? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/diagnosis. Updated August 14, 2018. Accessed January 8, 2019.

Liberman AL, Prabhakaran S. Stroke chameleons and stroke mimics in the emergency department. Curr Neurol Neurosci Rep. 2017;17(2):15.

Neuroimaging for acute stroke. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T474350/Neuroimaging-for-acute-stroke. Updated April 13, 2018. Accessed January 8, 2019.

Patient education: stroke prevention. EBSCO Nursing Reference Center website. Available at:https://www.ebscohost.com/nursing/products/nursing-reference-center. Updated June 29, 2018. Accessed January 9, 2019.

Stroke (acute management). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management. Updated November 27, 2018. Accessed January 8, 2019.

Stroke diagnosis. American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/Diagnosis/Stroke-Diagnosis_UCM_310890_Article.jsp#.VnrtTU2FPIU. Updated October 23, 2017. Accessed January 8, 2019.

tPA treatments for stroke. Jefferson University Hospitals website. Available at: http://hospitals.jefferson.edu/tests-and-treatments/tpa-treatments-for-stroke. Accessed January 8, 2019.

Last reviewed December 2018 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 1/7/2019