Tests to Identify a Stroke
What to do? Think FAST Exam
- Face - Does the face look uneven? Ask the person to smile
- Arm - Does one arm drift down? Ask the person to raise both arms
- Speech - Does their speech sound stranger? Ask the person to repeat
a simple phrase, for example "The sky is blue"
- Time - If you observe any of these signs, then it's time to call 9-1-1
Stroke is a medical emergency that requires
immediate treatment. Call 911 if someone is having stroke symptoms!
These tests may be performed if a stroke is suspected:
- A neurological exam may suggest increased intracranial pressure or decreased brain function. The person's specific symptoms can help tell which part of the brain is affected.
- An eye exam may show swelling of the optic nerve from pressure in the brain, or there may be changes in eye movement. Abnormal reflexes may be present.
The health care provider may hear an abnormal sound, called a "bruit", when using a stethoscope to listen to the carotid arteries in the neck.
Tests can help your doctor determine the type, location, and cause of the stroke and to rule out other disorders that may be responsible for the symptoms. Tests may include:
- Angiogram of the head is used to see which blood vessel is blocked or bleeding and help your doctor decide if the artery can be reopened using a thin tube. (Heart Institute)
- Electrocardiogram (ECG) may help diagnose underlying heart disorders. An electrocardiogram is a test that measures the electrical activity of the heart. This includes the rate and regularity of beats as well as the size and position of the chambers, any damage to the heart, and effects of drugs or devices to regulate the heart. The electrocardiogram (ECG, EKG) is used extensively in the diagnosis of heart disease, from congenital heart disease in infants to myocardial infarction and myocarditis in adults. Several different types of electrocardiogram exist. (Heart Institute)
- Echocardiogram is used if the stroke may have been caused by a blood clot from the heart. An echocardiogram is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain x-ray image and involves no radiation exposure. (Heart Institute)
- Carotid duplex (a type of ultrasound) will determine if narrowing of the neck arteries (carotid stenosis) led to the stroke. Carotid duplex is an ultrasound procedure performed to assess blood flow through the carotid artery to the brain. High-frequency sound waves are directed from a hand-held transducer probe to the area. These waves "echo" off the arterial structures and produce a 2-dimensional image on a monitor, which will make obstructions or narrowing of the arteries visible. (Heart Institute)
- Head CT or Head MRI or newer tests, called magnetic resonance angiography (MRA) or CT angiography, are used to determine the location and severity of the stroke and which blood vessel is blocked or bleeding. A cranial computed tomography (CT) scan is an imaging method that uses x-rays to create cross-sectional pictures of the head, including the skull, brain, eye sockets, and sinuses. (Outpatient Testing/ Radiology)