Brain Stroke Diagnosis
There are several ways in which a doctor can establish an accurate stroke diagnosis. The traditional way of diagnosing stroke implies a physical examination, certain laboratory tests and imaging tests which provide clear images of the inside of the brain.
The first step when establishing a stroke diagnosis is recognizing the first symptoms. These are sudden numbness or weakness of the face, arm or leg on one side of the body, sudden confusion, speech trouble, seeing problems, loss of balance or coordination, dizziness, severe headache with no apparent known cause.
Physical examination is performed in order to conclude if there are signs of a stroke. The doctor will check the airway, breathing, blood circulation and the patient’s vital signs. The examination of the head and extremities is required in order to rule out other conditions that may cause the same symptoms or to determine what is causing the stroke. The physician will also look for other signs of vascular diseases and he or she may use a stethoscope to check if there are any bruits in one of the two main arteries that supply blood to the brain. If the bruit exists, it is a sign of atherosclerosis.
The most effective methods to establish a stroke diagnosis are the imaging tests but additional laboratory tests or blood exams may be ordered to determine if the stroke is present or there are other conditions that should be taken under consideration such as infection or brain tumor.
The CT or the Computed Tomography is normally the first imaging test performed to establish stroke diagnosis and it is recommended to be ordered as soon as possible after the symptoms have appeared. The CT scan is able to provide x-ray images of the brain and it is very useful in locating a hemorrhagic stroke. The disadvantage of this test is that ischemic strokes are not showed until 48 hours after onset. This is basically the reason why doctors usually repeat CT scans even if they show nothing at the beginning. This is required in order to rule out the ischemic stroke.
The MRI or Magnetic Resonance Imaging test uses a magnetic field to obtain detailed and clear images of brain tissue and blood vessels in the neck and brain. They are normally used with a magnetic resonance angiography (MRA). They are useful imaging tests that provide clear images that could show a small-vessel infarct.
In some cases, the abnormalities that appear in the blood vessels may be caused by irregular heart rhythm or reduced blood flow to the heart so specialists may order an electrocardiogram is order to detect these abnormalities related to the heart.
Tests that reveal any abnormalities in what concerns the blood vessels in the brain or neck may be used for stroke diagnosis, such as angiograms, ultrasounds or positron emission tomography (PET).