There are a number of diagnostic exams that can be performed to determine if someone has had a stroke or is at risk for having one.
Physical examination.
Your doctor may be able to assess your risk for stroke during a routine physical examination. If your physician suspects that you may be at high risk, he or she will ask if you have experienced symptoms such as numbness or muscle weakness, speech or vision difficulties, or lightheadedness. By listening to the carotid artery through a stethoscope, the doctor may hear a rushing sound, called a bruit ("brew-ee") that suggests the artery may be obstructed. Physical exam is not always accurate, however, and further tests may be ordered.
Computed tomography (CT)
The first diagnostic test performed in the emergency room is usually a CT scan. CT uses computers to generate detailed pictures of the brain, and can confirm the diagnosis of stroke and tell whether the stroke is caused by a hemorrhage in the brain.
Ultrasound
A technique called doppler ultrasound that creates pictures using sound waves can determine whether there is blockage in the arteries that carry blood to the brain. Some physicians recommend ultrasound screening for those who have been diagnosed with atherosclerosis or other risk factors for carotid artery disease. In the ultrasound image shown here, the colors red and blue indicate direction of flow.
Magnetic Resonance Angiography (MRA)
Magnetic Resonance Angiography (MRA) is a non-invasive diagnostic technique that creates an image of the arteries in the brain. A magnetic resonance (MR) scanner uses harmless but powerful magnetic fields and radio waves to create detailed images of the body's tissues.
Angiography
An angiogram is an X-ray in which a contrast agent, or dye, is injected into a vein to highlight the blood vessels. With this exam, radiologists can pinpoint the exact location of blockage or bleeding in the brain. Angiography also is used to guide thin tubes called catheters to the site of the problem and administer treatments.
For patients having an angiogram, Magnetic Resonance Imaging (MRI) is a diagnostic test which may be performed to identify and further localize the site of the stroke and find the source. It may be able to quickly identify the area deprived of sufficient blood flow and guide further therapy.
