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Tests for a Stroke

A stroke is a medical emergency where blood stops flowing to a certain part of the brain because of a bleed (hemorrhagic stroke) or a clot in a blood vessel (ischemic stroke). Permanent brain damage can occur due to lack of oxygen; therefore, it is important to recognize stroke and start treatment immediately. The American Heart Association states that stroke is the third biggest killer in the United States (following heart disease and cancer) and the largest contributor to severe, long-term disability. There are several tests for stroke.

  1. Neurological Exam

    • When a person has a stroke, one side of his body may suddenly go numb or feel weak, making it difficult to walk. His speech may be slurred, he may have trouble seeing and he could be confused. He needs medical attention immediately. In the emergency room, a physician performs a neurological exam to check the functional capability of specific parts of the brain. Each question assesses, among other things, memory, vision and strength. A physician can figure out which part of the brain is affected by looking at areas of the test where the person did not do well.

    CT/CAT Scan

    • If stroke is suspected, a CT scan (or CAT scan--computerized axial tomographic scan) of the head is done right away. A CT uses x-rays to create images of the internal structures of the head. The exam takes about 10 minutes, causes little discomfort and requires no special preparation. The images allow physicians to determine whether neurological symptoms are the result of stroke or brain tumor. In the former, a CT helps identify the type of stroke (ischemic versus hemorrhagic) present.

    MRI

    • Magnetic resonance imaging (MRI), which uses magnetic fields to picture the brain and spinal cord, is far superior to CT when it comes to detail. If the CT scan confirms stroke, an MRI is done almost immediately to gather additional details about the person's condition. It can detect bleeding, aneurysms (bulging of blood vessel in brain) and other abnormalities of the brain and spinal cord. An MRI takes about an hour to perform and does not require special preparation other than removing all metal (jewelry).

    Other Tests

    • Other tests are not as urgent as CT or MRI and may be done sometime after the person exhibits symptoms of a stroke. The electroencephalogram (EEG), which records electrical activity of the brain, checks for seizures. A Doppler ultrasound of the carotids (arteries in the neck that go to the brain) determines if there is blockage. Blood may also be drawn to rule out other causes of stroke-like symptoms, such as infection, drug overdose and brain tumor.

    Time is of the Essence

    • A stroke needs to be diagnosed as soon as possible after symptoms appear so treatment can be initiated. With stroke, timing is everything; it can mean the difference between mild disability and severe dysfunction.

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