Tests to Identify a Stroke
Stroke is a medical emergency that requires immediate treatment. Call 911 if someone is having stroke symptoms!
What to do? BE FAST
The BE FAST acronym can help you identify signs of stroke. Remember, if you suspect that someone is having a stroke, it is important to get medical help right away.
- Balance: Trouble with balance or coordination
- Eyes: Blurred vision or sudden loss of vision in one or both eyes
- 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
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:
An 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.
A type of ultrasound, this procedure 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.
Computed tomography (CT scans) are high-tech x-ray scanners that use computer analysis to create cross section images (like slices) of the body, by combining multiple images into one, detailed picture showing bones, soft tissue and blood vessels.
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.
CTA of the Head and Neck
Computed tomography angiography (CTA) is used to determine the location and severity of a stroke and which blood vessel is blocked or bleeding. High-tech x-ray scanners and computer analysis can create images similar to those created with coronary artery catheterization.
CT Perfusion Imaging of the Brain
Computed tomography (CT) perfusion (blood flow) imaging is a medical test that shows which areas of the brain are supplied with blood. Combining a series of x-rays, the CT scan provides a detailed image of the brain which shows blockages and bleeding. This test can help to diagnose stroke as well as brain tumors and other disorders.
Electrocardiogram (EKG) 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 (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.
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.
Magnetic Resonance Imaging or MRI uses powerful magnets and radio frequency pulses to create images of organs and soft body tissue. This study can show the structure of the brain and how it is working. Functional MRI measures changes in blood flow with brain activity, which can help physicians evaluate the effects of stroke or other disease.
MRA of the Head and Neck
Magnetic Resonance Angiogram or MRA, is a medical test that uses a powerful magnet, radio waves and a computer to create pictures of blood vessels, helping to used to determine the location and severity of the stroke and which blood vessel is blocked or bleeding. In some cases, patients are given an injection of contrast material into the arm. The MRA of the head and neck helps the physician evaluate a patient for a stroke or aneurysm (weakness and bulging in an artery), a tumor, and can help identify reasons for memory loss
Doctors use Transesophageal Echocardiography (TEE) to obtain detailed images of the heart's structure, and if you have a stroke, this test helps your physician to check for blood clots in the chambers of your heart.
The test uses ultrasound (high frequency sound waves) to obtain the images. A thin tube with a tiny ultrasound transducer is passed down the throat and placed in the esophagus (food pipe), which is very close to the heart and the place where the best images of the heart and surrounding arteries can be obtained.
Patients receive medication to help calm them and to numb the throat during this test.