Magnetic Resonance Imaging (MRI)

MRI is one of the most important diagnostic tools used to evaluate patients suspected of having had a stroke. An MRI scanner uses powerful magnets and radio waves to produce detailed images of the brain and blood vessels. This allows doctors to determine if there has been any bleeding or blockages in the brain. For stroke patients, MRIs can identify what type of stroke occurred (ischemic or hemorrhagic), the location and size of any clots or bleeds, as well as show if there has been any permanent damage to brain tissue. Detecting these details is crucial for determining the best treatment plan.

Computed Tomography (CT) Scan

While MRI provides the most detailed brain images, the CT scan is often the initial imaging test performed on patients experiencing Stroke Diagnostics symptoms. This is because CT scans only take a few minutes to complete versus the 30 minutes or more required for an MRI. In the critical early hours after a stroke occurs, identifying life-threatening hemorrhages that require emergency surgery is priority over the fine details an MRI could provide. CT scans can clearly show any bleeding in the brain or signs of a blockage, quickly guiding first responders on next steps like administering clot-busting drugs or performing surgery.

Magnetic Resonance Angiography (MRA)

An MRA uses the same powerful MRI magnets but focuses specifically on imaging the blood vessels of the head and neck. This test helps doctors evaluate if a patient is experiencing a transient ischemic attack (TIA), also known as a mini-stroke, or determine the severity and location of any blockages or narrowing of arteries that may have caused an ischemic stroke. By detecting plaque buildup or other vascular abnormalities, MRAs provide crucial information on underlying conditions and future stroke risks. They can also help interventional specialists like neurosurgeons plan endovascular clot removal procedures.

Carotid Ultrasound for Stroke Diagnostics

This non-invasive test uses sound waves to evaluate the carotid arteries, which are the two major arteries located on each side of the neck that supply blood to the brain. A doppler carotid ultrasound can detect any buildup of plaques or fatty deposits along the artery walls, called carotid stenosis, as well as measure the degree of narrowing. Specifically for ischemic strokes caused by blocked carotid arteries, these scans help doctors determine if a patient may benefit from carotid endarterectomy surgery to remove the blockage and reduce the chance of another stroke.

Transcranial Doppler (TCD)

A TCD ultrasound focuses on assessing blood flow velocity through the major arteries within the brain. This exam is performed through the patient's intact skull and does not require any contrast agents or radiation exposure. For stroke patients, TCDs provide valuable information for neurologists about the status of brain circulation. Abnormal blood flow readings can indicate blockages, vasospasms (spasm of blood vessels), or other hemodynamic issues that increase stroke risk. TCD monitoring is also useful during some thrombolytic clot-busting therapies to check for any reperfusion hemorrhages in real-time.

Electrocardiogram (ECG or EKG)

An EKG is a basic cardiac test involved in the initial workup for many stroke patients. This non-invasive procedure records the heart's electrical activity through sensors attached to the skin of the arms, legs and chest. It checks heart rate, rhythm and for any signs of atrial fibrillation (AFib), a serious irregular heartbeat that greatly increases the odds of having an ischemic stroke. Detecting AFib or other underlying heart conditions is crucial for choosing the appropriate long-term prevention strategies. EKGs also help rule out potential cardiac causes of a stroke like a blood clot forming in the heart.

Blood Tests for Stroke Diagnostics

Several common blood tests are ordered on stroke patients to evaluate risk factors and screen for possible underlying medical conditions or infections. A complete blood count evaluates red and white blood cell levels, hematocrit, and platelet counts which could indicate anemia, infection or bleeding disorders. Fasting blood glucose and HbA1c tests screen for diabetes, a major contributor to stroke risk. Cholesterol panels assess lipid levels, and tests for C-reactive protein measure inflammation levels. Liver and kidney function tests also evaluate overall health status that may impact thrombolysis or other treatments.

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