Diagnosis of Stroke
The ability to determine the precise location of a stroke, the cause of the stroke and the amount of damage is essential for making treatment decisions. Physicians must quickly determine whether the stroke is ischemic or hemorrhagic before appropriate treatment can begin.
Physicians unanimously agree that not only are the following screening tools used most frequently to determine stroke risk, but also become diagnostic tools if a person is having a stroke:
A physician will conduct a physical exam in order to assess the overall status of the patient. A detailed neurological assessment is performed by the physician to determine a possible location of the stroke occurring in the brain.
Basic Laboratory Tests
Physicians may test for diabetes or cholesterol panel. They may also check for genetic or acquired conditions that predispose the patient to form blood clots.
Computed Tomography (CT) Scan
This diagnostic test is a special radiographic technique that uses a computer to generate multiple X-ray images of the brain. It reveals soft tissue structures not shown by conventional radiology. Computed tomography scans allow physicians to determine whether a patient has suffered an ischemic or hemorrhagic stroke.
The Stroke Center at St. Joseph Mercy Oakland has a State-of-the Art, 320-Slice CT Scanner made by Toshiba Aquilion™. The Aquilion™ ONE is the most advanced CT system on the market.
Some of its key capabilities include:
Computed Tomographic Angiography (CTA)
- Delivers the highest quality CT images so physicians can make more accurate diagnoses
- Provides a uniquely comprehensive exam that reduces diagnosis time from hours or days to mere minutes for patients experiencing symptoms of heart conditions, stroke or other diseases
Images and entire organ, like the heart or brain in a single rotation.
Computed tomographic angiography combines the use of X-rays and computerized images to visualize the blood flow in arterial and venous vessels throughout the body, especially in the neck and brain. It can detect blockages, cholesterol plagues, aneurysms and other abnormalities in blood vessesl.
Computed Tomography Perfusion (CTP)
Stroke imaging serves two purposes: first, to diagnose or confirm the occurrence of a stroke and second, to assess the amount of potentially salvageable brain tissue and irreversibly damaged tissue. CT Perfusion (CTP) is a tool that has been successfully employed to assess the extent of salvageable tissue.
Magnetic Resonance Imaging (MRI)
A special imaging technique that generates very clear pictures of soft tissues, the brain and the spinal cord. An MRI is particularly useful in exposing the damage done to brain tissue by an ischemic stroke. These scans have good precision in identifying the exact location of the stroke and the severity of the stroke.
Magnetic Resonance Angiography (MRA)
A non-invasive method of vascular imaging and determination of internal anatomy with or without injection of dye, but without exposure to radiation. This technique is used particularly for cerebral (head) arteries and veins and also generates information concerning collateral arteries.
A useful diagnostic and screening tool that produces an ultrasound of the neck. Sound waves are utilized to illustrate possible blockages in the arteries of the neck. It can also measure the speed at which blood is flowing to the brain.
This procedure involves injecting a dye visible in X-rays to determine if the arteries are damaged. The X-rays alert physicians of irregularities of the blood vessels such as blockages or aneurysms.
An Echocardiogram (ECHO) is a test that uses high frequency sound waves to image the heart and its surrounding tissues. Many physicians use this test to reveal if a heart problem may contribute to a patient's risk of experiencing a stroke.