Diagnosis of a Stroke

When a patient arrives at one of Beaumont's emergency departments, a rapid, accurate diagnosis of a stroke and its exact cause and location is essential. It is critical to diagnose a stroke as soon as possible, as the treatment for stroke depends on the type and source of the stroke, location of the injury to the brain and how long the brain tissue has been without blood supply.

Other conditions may have symptoms similar to stroke and may need to be ruled out in order to diagnose a stroke. Some of these conditions include seizures, fainting, migraine, heart problems or other general medical conditions.

In addition to a physical examination and laboratory tests, our physicians may use a variety of advanced imaging diagnostic tests to diagnose a stroke.

In the emergency room, your doctor or stroke emergency team will:

  • ask you when the symptoms of the stroke started
  • ask you about your medical history
  • conduct a physical and neurological examination
  • order certain laboratory (blood) tests
  • perform imaging tests to help determine what kind of stroke you are having
  • request additional tests that might be needed

Imaging Tests

CT scan (computed tomography)

An imaging test of the brain that uses radiation to create a picture (like an X-ray) of the brain. It’s usually one of the first tests given to a patient with stroke symptoms as test results give valuable information about the cause of stroke and the location and extent of brain injury.

MRI (magnetic resonance imaging)

An MRI uses a large magnetic field to produce an image of the brain. Like the CT scan, it shows the location and extent of brain injury. The image produced by MRI is sharp and detailed, so it’s often used to diagnose small, deep injuries.

Echocardiogram

An ultrasound imaging procedure used to assess the heart’s function and structures. It can be used to check for conditions such as heart disease, congenital birth defects, heart failure, pericarditis (an inflammation of the lining of the heart) or disease of the valves which might identify the cause of the stroke.

TEE

A transendoscopic echocardiogram, which looks at the same structures as a regular echocardiogram but is performed using an endoscope down the throat to look directly at the heart.

CT Perfusion

A regular CT scan that uses dye/contrast to look at all surrounding arteries, if needed, to quickly diagnose stroke, assess condition of the vessels and determine potential treatment.

Blood Flow Tests

Carotid artery ultrasound

A carotid artery ultrasound may be ordered if your doctor hears an abnormal sound over your carotid artery caused by disturbances in the blood flow. This diagnostic test takes images of the blood flowing through the arteries and it can detect how severe the narrowing is from plaque buildup.

Cerebral angiography/cerebral arteriography

A cerebral angiography/cerebral arteriography can be performed to diagnose and show the degree of carotid artery stenosis. This test feeds a catheter from your groin, through your aorta and into the carotid artery. An injectable contrast dye is then inserted into the artery while images of the area are captured. This dye allows your doctor to view the arteries in a more enhanced field of view to detect any vessel abnormality. This test is similar to a catheterization to the heart.

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