Each type of stroke has a different type of treatment, so it is very important for the physician to determine the cause of the stroke, as well as the location, as quickly as possible.
Here are some of the most commonly used tests to diagnose a stroke or TIA:
Medical History/Physical & Neurological Examination - When the patient arrives at a hospital, a healthcare professional first will ask the patient or a companion what happened and when the possible stroke symptoms began. In a neurologic exam, the muscles and nervous system are checked. The doctor will test reflexes, coordination, sensation, speech, memory and cognition.
CT Scan – A computerized axial tomography (CT or CAT) scan uses X-rays to create a 3-dimensional picture of the brain. This is often one of the first imaging tests done to evaluate someone with stroke symptoms. CT test results give valuable information about the cause of stroke and the location and extent of brain injury. Before the CT scan is performed, dye may be injected through the patient’s vein.
MRI, Open MRI and High Strength MRI - Imaging tests that use magnetic waves instead of X-ray to produce detailed, 3-dimensional images of internal structures and organs in the body. Due to its high level of sensitivity, MRI is considered especially useful when the stroke involves small blood vessels.
Carotid Ultrasound – a painless test that uses high-frequency sound waves to create pictures of the two larger arteries in the neck. These arteries, called carotid arteries, supply the brain with blood. Carotid ultrasound shows whether plaque has narrowed the carotid arteries.
Angiography - a sophisticated X-ray examination of the blood vessels leading to and inside the brain. The procedure entails an injection of contrast dye that outlines the blood vessels, making them visible in the x-ray images. All this begins with a catheter, inserted through a sedated patient’s femoral artery near the right hip.
Electroencephalogram – In this test, also known as EEG, small metal discs (electrodes) are placed on a person's scalp to pick up electrical impulses. These electrical signals are printed out as brain waves.
Echocardiogram – This test, also known as an EKG or ECG, helps doctors identify problems with the electrical conduction of the heart. When the heart has a defect in electrical conduction, it stops beating rhythmically and it is said to be suffering from arrhythmia. Some arrhythmias, such as atrial fibrillation, cause the formation of blood clots inside the heart chambers. These blood clots sometimes migrate to the brain and cause a stroke.