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Stroke Diagnosis

Stroke: Diagnosis

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1. ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein)

These are non specific blood tests which are conducted in the later stages to evaluate complications in the bloodstream. These are minimally invasive tests, which require the patient’s blood sample for analysis. The tests usually takes about 5 minutes, and results may take up to 2 days.

2. Complete blood count (CBC)

A complete blood count is a minimally invasive test performed to check the patient for anemia and other abnormalities in the blood in acute cases of stroke. A blood sample is taken and tested for white blood cells count and iron deficiency. The test takes about 5 minutes and the patient need not be under observation before or after the test. 

3. Electrocardiogram (ECG)

An electrocardiogram (ECG) is a non-invasive sonogram of the heart, performed to detect arrhythmia (abnormal heart rhythm) which might have resulted in a clot in the heart. The clot can further spread to the blood vessels in the brain through the bloodstream, resulting in a stroke. The patient is made to lie and some gel is applied on the chest region. ECG leads are attached to six pre-defined positions on the chest and the electrical impulses of the heart are transmitted through the leads. The test usually takes about 15 minutes and the patient is not required to be under observation.

4. Carotid doppler ultrasound

The carotid doppler ultrasound is a non-invasive imaging test performed to visualize the carotid arteries for clots, or decrease in blood supply. A transducer is used to send high frequency sound waves through the tissues to reflect on-screen images of the arteries. The test takes about 15 to 30 minutes for completion. The patient is not required to be kept under observation before or after the test.

5. Arteriography

Arteriogragphy is a specialized form of angiogram, conducted to visualize the blood vessels of the brain is case of a suspected stroke. Arteriography is an invasive diagnosis in which a long, flexible tube (catheter) is inserted in the patient’s groin through a small incision. The catheter is then advanced into the cartoid or vertibral artery. A contrast material (dye) is injected through the catheter and X-ray images of the arteries are taken. The procedure takes about 20 to 30 minutes for completion. The catheter is then removed and the incision is sutured. The patient is usually kept under observation overnight after the procedure.

6. Computerized tomography (CT) with angiography

Computerized tomography with angiography is a minimally invasive, specialized CT scan conducted to identify a blood clot or irregularity in blood flow in any artery of the brain. In case of a suspected stroke, this test is performed, preferably at the time of the normal CT scan. Following this procedure, the patient is intravenously injected with a contrast material (dye) before the CT scan imaging. The imaging results can help to identify blood clots within the brain. The test takes about 15 to 30 minutes for completion. A patient with a suspected stoke is kept under observation even after the test.

7. MRI scan

Magnetic resonance Imaging, or MRI scan, is a non-invasive test conducted for neurological assessment of the brain. It is not among the first tests to be conducted in a case of stroke as it is much more detailed and time consuming as compared to a CT scan. In this test, the patient is placed on a movable bed which is inserted into a big doughnut shaped machine with a large magnet. Magnetic waves are generated which are recorded and displayed on a computer for a 3D view of the brain. The test takes about 30 to 60 minutes to complete, and the patient is not required to be kept under observation before or after the test.

8. CT scan

Computerized tomography, or CT scan, is a non-invasive imaging test performed to visualize the brain for bleeding or masses within. This helps rule out any other condition that may mimic a stroke. A series of X-ray images are viewed on a computer for evaluating the condition. The test usually takes about 5 to15 minutes and the patient is kept under observation for further diagnosis and treatment after the test.

9. Physical examination

A thorough physical examination of the symptoms provides the building block for further diagnosis. The physician (preferably a neurologist) may inquire the family about the symptoms, when they started, and evaluate if the symptoms are still present. Possible conditions which mimic a stroke are to be ruled out before a clot bursting drug can be utilized. This is an information test which could help in stabilizing the patient before a further diagnosis is performed. A stroke is a critical emergency and the patient is kept under observation throughout.

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