Table of ContentsView AllTable of ContentsAt-Home Stroke AssessmentLabs and TestsImagingDifferential DiagnosesFrequently Asked QuestionsNext in Stroke GuideCoping With Stroke
Table of ContentsView All
View All
Table of Contents
At-Home Stroke Assessment
Labs and Tests
Imaging
Differential Diagnoses
Frequently Asked Questions
Next in Stroke Guide
Strokediagnosis requires a careful and fast medical examination, often with the aid of medical technology. If you ever have a stroke evaluation, your examination will include a neurological examination, computed tomography (CT) scans, and other imaging tests.
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If you suspect someone is having a stroke, a simple three-step test known as theCincinnati Pre-Hospital Stroke Scale(CPSS) can help in the determination.
If the person can do all of the following, it is unlikely they are having a stroke:
A 2018 study published in theJournal of Emergencies, Trauma, and Shockfound CPSS is 81% accurate in determining whether someone is having a stroke.
If yoususpect a stroke, call 911or rush to your nearest emergency room. Regardless of the results of the CPSS, a professional, and immediate, evaluation is needed. The sooner a stroke can be diagnosed and treated, the better the outcome.
If your healthcare provider suspects a stroke, the first test is a neurological exam to uncover whether there is a problem in brain function that might confirm a person is actually having a stroke.
Each part of the neurological exam tests a different area of the brain, including:
National Institutes of Health Stroke Scale
Electrocardiogram
This test, also known as an EKG or ECG, helps healthcare providers identify problems with the electrical conduction of the heart. Normally, the heart beats in a regular, rhythmic pattern that promotes smooth blood flow toward the brain and other organs. But when the heart has a defect in electrical conduction, it may beat with an irregular rhythm. This is called an arrhythmia, or anirregular heartbeat.
Some arrhythmias, such as atrial fibrillation, cause the formation of blood clots inside the heart chambers.These blood clotssometimes migrateto the brain and cause a stroke.
Blood Tests
For the most part,blood testshelp healthcare providers look for diseases known to increase therisk of stroke, including:
There are several imaging tests that are used for diagnosing and determining the extent of a stroke.
Computed Tomography (CT)
This test is performed in the emergency room to detect ahemorrhagic stroke. CT scans are good tests for this purpose not only because they easily detect bleeding inside the brain, but because they can be performed quickly.
CT scans can also revealischemic strokes, but not until six to 12 hours after stroke onset.
Magnetic Resonance Imaging (MRI)
This is one of the most helpful tests in the diagnosis of stroke because it can detect strokes within minutes of their onset. MRI images of the brain are also superior in quality to CT images. A special type of MRI called magnetic resonance angiography, or MRA, lets healthcare providers visualize narrowing or blockage of blood vessels in the brain.
Transthoracic Echocardiogram (TTE)
This test, also known as an “echo,” uses sound waves to look for blood clots or other sources of emboli inside the heart, as well as abnormalities in heart function that can lead to blood clot formation inside the heart chambers.
TTEs are also used to investigate if blood clots from the legs can travel through the heart and reach the brain.
Transcranial Doppler (TCD)
Another important use for the TCD is the assessment of blood flow through blood vessels in the area of a hemorrhagic stroke, as these blood vessels have a propensity to undergo vasospasm—a dangerous and sudden narrowing of a blood vessel that can block blood flow.
Cerebral Angiography
Stroke doctors use this test to visualize blood vessels in the neck and brain. A special dye, which can be seen using X-rays, is injected into the carotid arteries, which bring blood to the brain. If a person has a partial or total obstruction in one of these blood vessels, the pattern of dye will reflect it.
Depending on the degree of narrowing and the symptoms, surgery might be needed to remove the plaque from the affected artery.
Cerebral angiography can also help healthcare providers diagnose the following common conditions known to be associated with hemorrhagic stroke:
After a stroke is diagnosed, sometimes a new battery of tests needs to be performed in order to find outthe causeof the stroke.
Leg Ultrasound
Healthcare providers usually perform this test on stroke patients diagnosed with apatent foramen ovale(PFO). The test uses sound waves to look for blood clots in the deep veins of the legs, which are also known as deep venous thrombosis (DVT).
In working to reach a diagnosis, a healthcare provider will also consider these other potential diagnoses, which present similarly to stroke (though they are unrelated).
Neuropathy
Dementia
Parkinson’s Disease
Parkinson’s diseasesymptoms primarily include movement abnormalities, such as tremors and stiffness. Generally, the symptoms of Parkinson’s disease are gradual and affect both sides of the body, in contrast to the one-sided and sudden symptoms of stroke.
Migraine Headaches
Migraine headaches associated with neurological deficits almost always improve. However, it is not possible to know for certain whether neurological symptoms associated with migraines are the sign of an impending stroke. There is a slightly increased risk of stroke among people who experience these types of migraines. So if you have been diagnosed with migraines with aura, it is advisable to be under the care of a healthcare provider.
Myasthenia Gravis
Multiple Sclerosis
Multiple sclerosis (MS) is a relatively common disease that affects the brain, the spine, and the optic nerves of the eyes. MS, like stroke, usually produces symptoms that typically include weakness, vision changes, and sensory deficits, however, they do not occur as suddenly as a stroke.
TIA
Another type of stroke-like episode called atransient ischemic attack (TIA)is a temporary vascular interruption in the brain that resolves before causing permanent damage.
If you experience stroke symptoms that get better on their own, then that could be a TIA. But a TIA is not something to gloss over. Most people who experience a TIA go on to have a stroke if they don’t start taking medication to prevent one—and no one can predict whether a TIA means that a stroke will happen within an hour or within a few months.
Frequently Asked QuestionsEach year, more than 795,000 people in the United States have a stroke. About one in four of them have had a previous stroke.Thesignsof a stroke can include:Sudden numbness or weakness in the arm, leg, or face, especially on one side of the bodySudden confusion, trouble speaking, problems understanding speechSudden trouble seeing in one or both eyesSudden difficulty walking, dizziness, lack of coordination, loss of balanceSudden severe headache with no known causeIf you notice any of these signs or symptoms, call 911 or seek immediate emergency care.
Each year, more than 795,000 people in the United States have a stroke. About one in four of them have had a previous stroke.
Thesignsof a stroke can include:Sudden numbness or weakness in the arm, leg, or face, especially on one side of the bodySudden confusion, trouble speaking, problems understanding speechSudden trouble seeing in one or both eyesSudden difficulty walking, dizziness, lack of coordination, loss of balanceSudden severe headache with no known causeIf you notice any of these signs or symptoms, call 911 or seek immediate emergency care.
Thesignsof a stroke can include:
If you notice any of these signs or symptoms, call 911 or seek immediate emergency care.
Stroke Treatment: Before, During, and After
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Powers WJ, Rabinstein AA, Ackerson T, et al.2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2018 Mar;49(3):e46-e110. doi:10.1161/STR.0000000000000158
Centers for Disease Control and Prevention.Stroke facts.
Centers for Disease Control and Prevention.Signs and symptoms of stroke.
American Stroke Association.About stroke.National Institutes of Health.NIH Stroke Scale.
American Stroke Association.About stroke.
National Institutes of Health.NIH Stroke Scale.
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