Stroke Symptoms and Diagnosis

Symptoms of stroke will depend on the type of stroke and which area of the brain is affected but they often appear without warning. Common initial symptoms of a stroke include:

  • Dizziness
  • Severe headache
  • Memory loss
  • Confusion
  • Trouble walking or loss of balance
  • Trouble with speaking and understanding
  • Sudden vision problems (e.g. blurred vision, blindness in one eye)
  • Sudden numbness, paralysis or weakness, particularly on one side of the body such as an arm, leg or face.

The National Stroke Association recommends the F.A.S.T. test to check for signs and symptoms that may be caused by stroke.

Face: Ask the person to smile. Does one side of the face droop?

Arms: Ask the person to raise both arms. Does one arm drift downward?

Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

Time: If you notice any of the above signs, call 911 immediately.

For a person having a stroke, every minute is important. Acting F.A.S.T. can help stroke patients get the treatments they need. The stroke treatments that work best are available only if the stroke is recognized and diagnosed within 3 hours of the first symptoms.

How a Stroke is diagnosed?

To diagnose a stroke, your doctor may use several tests to determine your risk of stroke. These include:

Physical examination

Your doctor will ask you or your family member about symptoms you’ve been having, when they started and what you were doing when they began. Your doctor will then evaluate whether these symptoms are still present.

Your doctor will check your blood pressure and use a stethoscope to listen to your heart and to listen for a whooshing sound over your neck arteries, which may indicate atherosclerosis. Your doctor may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or clots in the blood vessels at the back of your eyes.

Blood tests

You may have several blood tests to find out how quickly the clots occur, the levels of particular substances in the blood, including clotting factors and whether or not an infection is present.

Imaging test

A type of test that uses different forms of energy, such as x-rays, ultrasound, radio waves, and radioactive substances, to create detailed pictures of areas inside the body.

You will probably get at least one imaging test that allows your doctor to see inside your brain to find out how much damage was done and where the stroke occurred. Some imaging tests you may get include:

  • Computed Tomography (CT) scan
    This is usually the first test done for a patient with symptoms of possible stroke. The CT scan uses X-rays to capture pictures of the brain. It can show bleeding in the brain or damage to brain cells. The CT scan also can find other problems that can cause stroke symptoms.

    During the scan, your doctor may inject a dye into your bloodstream to help improve the clarity of the CT image and look at the blood vessels that supply the brain.

    If it’s suspected you’re experiencing a major stroke, a CT scan is usually able to show whether you have had an ischemic stroke or a hemorrhagic stroke.

  • Magnetic resonance imaging (MRI)
    MRI uses powerful magnets and radio waves to create a detailed picture of your brain. It can show the location of injury from a stroke. MRI also can show any bleeding or blood flow problems. The image created is sharper and more detailed than a CT scan, so it is often used to diagnose small, deep injuries of the brain.
  • Computed Tomographic Angiography (CTA)
    In CTA, a special substance is injected into a vein and images are taken of the blood vessels to look for abnormalities such as an aneurysm. This test gives a picture of the blood flow through the vessels. This allows the size and location of blockages to be reviewed. This test is very valuable in diagnosing aneurysms and malformed blood vessels.
  • Carotid ultrasound
    In this test, sound waves were used to create detailed images of the inside of the carotid arteries in your neck. It shows whether plaque has built up and/ or blockage is present in the carotid arteries.

    This test can be used to investigate the carotid arteries for several reasons, but the information here applies only to stroke evaluation.

  • Electrocardiogram (ECG or EKG)
    This test detects and get information of your heart’s electrical activity. It sometimes the only method of detecting irregularities in heart rhythm, such as atrial fibrillation, that can lead to the forming of blood clots. These blood clots can cause stroke by forming in the heart and then getting lodged in a small artery of the brain.

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