Diagnosing A Stroke: Stroke

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Diagnosing a stroke

Time is of the essence in treating a stroke. Brain tissue that is starved of blood and oxygen (ischemic), whether because of an ischemic or hemorrhagic stroke, may not yet be dead (infarcted) — offering a chance to limit brain damage. To deliver the best care, medical professionals first need to rule out other possible causes of your symptoms and then precisely diagnose the type of stroke that has occurred. Diagnosis, in turn, guides treatment and prevention strategies.

For example, an ischemic stroke caused by an embolus from a thrombus (blood clot) that formed on an atherosclerotic plaque might be treated with a combination of clot-busters and anticoagulants, followed by preventive treatment to reduce blood pressure and improve your cholesterol levels. But a hemorrhagic stroke caused by the rupture of a berry aneurysm may be treated with a combination of surgery, to remove excess blood and reduce pressure on the brain, and an inter-arterial procedure such as coiling, to prevent another rupture.

To determine the extent and location of the ischemic or infarcted brain tissue, the doctor will view both the arteries and brain with Doppler ultrasound and other types of imaging technology. This will help confirm the exact subtype of stroke or TIA. It is also essential that the doctor accurately identify the blood vessel pathology involved (see "Subtypes and causes of stroke"). Only then can precise therapy be directed to treating the arterial pathologic process that is the source of the problem and limiting brain damage as much as possible. Strokes of different types and causes require different treatments. Imprecise therapy that ignores the pathologic cause and timing of a stroke not only delays proper treatment, but also could increase the chances of long-term disability and even be life-threatening.

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Last updated:	January 23, 2007