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DIAGNOSTIC EXAM

CTA and CTP can help physicians decide on the best therapy for a patient experiencing a stroke.Tests that View the Brain. MR) An MRI uses magnetic fields to produce a 3-dimensional image of your head. . Images that detect blood flow. hemorrhagic stroke. a procedure called MR angiography (MRA). called CT perfusion (CTP). A CT scan can be used to diagnose ischemic stroke. To improve the detection and characterization of stroke.  MRI scan (Magnetic resonance imaging. Computed axial tomography) A CT scan uses X-rays to produce a 3-dimensional image of your head. Physicians use CT of the head to detect a stroke from a blood clot or bleeding within the brain. The MR scan shows the brain and spinal cord in more detail than CT. In CTA. and spinal cord. MR can be used to diagnose ischemic stroke. Images of blood flow are produced with a procedure called MR perfusion (MRP). or Spinal Cord  CT scan (CAT Scan. and other problems involving the brain. . Physicians use MRI of the head to assess brain damage from a stroke. The combination of CT. a contrast material may be injected intravenously and images are obtained of the cerebral blood vessels. Skull. hemorrhagic stroke. and other problems of the brain and brain stem. may be obtained at the same time. brain stem. CT angiography (CTA) may be performed. MR is also used to image the cerebral vessels.

Tests that View the Blood Vessels that Supply the Brain  Carotid doppler (Carotid duplex. which are located on each side of the neck and carry blood from the heart to the brain. Doppler ultrasound produces detailed pictures of these blood vessels and information on blood flow. and to show the blood flowing to your brain. . Carotid ultrasound) Painless ultrasound waves are used to take a picture of the carotid arteries in your neck.  Transcranial doppler (TCD) Ultrasound waves are used to measure blood flow in some of the arteries in your brain. Physicians use a special ultrasound technique to check for narrowing and blockages in the body's two carotid arteries.

including narrowing. or malformations (such as aneurysms or arterio-venous malformations). X-ray images show any abnormalities of the blood vessels. but the results are the most accurate. blockage. MRA (Magnetic resonance angiogram) This is a special type of MRI scan (see above) which can be used to see the blood vessels in your neck or brain.  Cerebral arteriogram (Cerebral angiogram. . Cerebral arteriogram is a more difficult test than carotid doppler or MRA. and a special dye is injected into the blood vessels leading to your brain. Digital subtraction angiography. [DSA]) A catheter is inserted in an artery in your arm or leg.

Sometimes the EKG is recorded continuously over days. TEE).  Electrocardiogram (EKG. TTE) or deep in your throat (trans- esophageal echocardiogram. The ultrasound probe may be placed on your chest (trans-thoracic echocardiogram. Cardiac echo. TEE) Painless ultrasound waves are used to take a picture of your heart and the circulating blood. TTE. . 3-10 electrical leads are attached to your chest. ECG) This is a standard test to show the pattern of electrical activity in your heart.Tests that View the Heart or Check its Function  Echocardiogram (2-d echo. arms and legs. with the signals sent to a portable recorder (Holter monitor) or by radio to a hospital monitoring station (telemetry).

spinal tap) A needle is inserted in your lower back to obtain a sample of the fluid (cerebrospinal fluid.  Lumbar puncture (LP. However. LP may also be needed if your doctor suspects a nervous system infection (such as meningitis) or inflammation. LP is not routinely used for diagnosis of ischemic stroke. CSF) which surrounds your brain and spinal cord.Other Neurologic Tests  Electroencephalogram (EEG) The EEG measures your brain waves through several electrical leads painlessly attached to your head. LP is often required if subarachnoid hemorrhage (bleeding from a cerebral aneurysm) is suspected. . but would be ordered if your doctor thinks that you may have had a seizure. EEG is not routinely used for stroke diagnosis.

. Biopsy is used to diagnose lesions (such as tumors) which cannot be identified by CT or MRI scan. Electromyogram / Nerve conduction test (EMG / NCV) This test records the electrical activity of the nerves and muscles. often only when cerebral vasculitis is suspected. It is very rarely used for stroke diagnosis. EMG is not used for stroke diagnosis.  Brain biopsy This is a surgical procedure in which a small piece of the brain is removed for microscopic examination. but might be needed if your doctor suspects a problem with the nerves in your arms or legs.

◦ Blood sugar.Other initial tests recommended for stroke include:  Blood tests to help your doctor make choices about your treatment and to check for conditions that may cause symptoms similar to a stroke. . Tests may include: ◦ Complete blood count (CBC). ◦ Liver and kidney function. ◦ Prothrombin time and INR (a test that measures how long it takes your blood to clot). ◦ Electrolytes.