Screening for stroke will begin with a physical exam and the doctor asking the patient (or a family member) about risk factors for stroke, including smoking, heart disease and family history, along with information about when the symptoms began. During the physical exam, the physician will check the patient’s mental alertness, coordination and balance, and look for numbness in the face, arms or legs, confusion, and trouble with vision or speaking. In addition, the doctors will look for signs of carotid artery disease, which is a common cause of ischemic stroke, by listening to the patient’s carotid arteries with a stethoscope.
In addition, blood tests and imaging tests may be used in diagnosing a stroke or transient ischemic attack. Some diagnostic tests for stroke include:
- Brain computed tomography: A brain CT scan is a painless test that uses x-rays to generate detailed images of the brain. It can show bleeding in the brain or cell damage, and may shed light on the condition causing the symptoms.
- MRI: An MRI, which uses magnets and radio waves to create images of internal structures and organs, may be used instead of or in addition to a brain CT scan.
- Computed tomography arteriogram (CTA) and magnetic resonance arteriogram (MRA): These imaging tests can show the large blood vessels in the brain, giving doctors more information about the site of a blood clot.
- Carotid ultrasound: This test uses sound waves to generate images of the insides of the carotid arteries, which supply oxygen-rich blood to the brain.
- Cerebral angiogram: This procedure uses a contrast dye and x-rays to determine how blood is flowing through the brain.
- Echocardiogram: This is a test that records a patient’s heart’s electrical activity, and shows how fast a heart is beating and whether its rhythm is steady or irregular. It can help detect heart problems, such as an arterial fibrillation or previous heart attack, that may have led to the stroke.
- Echocardiography: This procedure uses sound waves to generate images of the heart of give doctors information about the size and shape of the heart and how well the heart chambers and valves are working.
- Blood glucose test: Low glucose levels in the blood may cause symptoms similar to stroke
- Platelet count: This blood test measures the number of platelets—cell fragments that help the blood clot—in the blood. Abnormal platelet levels may indicate a bleeding disorder or a thrombotic disorder.