Stroke diagnosis requires quick medical attention so all tests can be carried out to get the most suitable treatment which will lead to good recovery.
Once the person with the signs and symptoms of acute stroke or mini stroke has been taken to a hospital, a doctor will get as much information as possible to make a diagnosis. The doctor will ask and go over what happened with the patient and will carry out exams and tests.
Firstly it’s critical for the doctor to see if the patient has had an ischemic or hemorrhagic stroke and to also check for other conditions that show symptoms close to a stroke.
Tests and Exams
A computed tomography scan (CT) will be carried out, which is a number of x-rays that shows if the brain is bleeding and will show if there is a hemorrhagic stroke. CT scans can see if there is an ischemic stroke 6 to 12 hours after acute ischemic stroke.
Magnetic resonance imaging (MRI) can also be used as an effective stroke test within minutes of onset. MRI is used to detect what damaged has been caused to the brain. As there is a better standard of images than the CT scan, this test is a huge help in the diagnosis of a stroke. Doctors can also use a magnetic resonance angiography (MRA) to see blocked or narrowed blood vessels in the brain.
Electrocardiogram (ECG) can help doctors find problems with the heart. The heart normally beats in a smooth pattern which pumps blood to the brain and other organs in the body. When the heart has a fault, it will stop beating in a rhythm which is called arrhythmia (irregular heartbeats).
Atrial fibrillation can cause blood clots in the heart chambers which can then lead to the brain and cause a stroke.
Blood tests for things such as diabetes, high cholesterol, blood clotting disorders and liver and kidney function can help doctors find symptoms close to a stroke and to find suitable treatments.
Cerebral angiography is used to see blood flow through the blood vessels to the brain. A dye is injected in to the carotid arteries which can be seen by an x-ray to see if there is a blockage of a blood vessel.
Carotid duplex is a test to diagnose carotid stenosis which is fat deposits on blood vessel walls. This is done by sound waves to check blood flow through the blood vessels.
Transthoracic echocardiogram (TTE) can be used if a doctor thinks the stroke could have been caused by a problem of the heart. The test uses sound waves to check for blood clots in the heart. It is also used to investigate irregularities in the heart which could lead to blood clots to form in the heart chambers.
Stroke Scale
A doctor can use The National Institute of Health Stroke Scale (NIHSS) to check the severity of the stroke. The scoring system is from 0 to 42, with zero being no stroke to forty two being the most severe type of stroke. The current guidelines of the NIH stroke scale are set out below:
• 0 is No stroke
• 1 – 4 is Minor stroke
• 5 – 15 is Moderate stroke
• 16 – 20 is Moderate/Severe stroke
• 21 – 42 is Severe stroke