Stroke Diagnosis & Treatment

Diagnosis

Source: American Stroke Association About Stroke and National Stroke Association Signs and Symptoms

If someone is thought to have had a stroke, the medical staff will:


• Get a medical history
• Do a physical and neurological exam
• Get a CT or MRI scan
• MRI and CT both can show the location and severity of the brain injury.
• Blood flow tests
• These tests will show the condition of the arteries.
• Examples include: B-mode imaging, Doppler testing, and duplex scanning.

Click the following links for more information about NIH Stroke Scale courses (AHA Professional Education Center) or more information about Advanced Stroke Life Support (ASLS) classes.

Preventive Treatment

• Antiplatelets
  • Medications, such as aspirin, that interfere with blood's ability to form clots.
  • See the ENCSN Aspirin Page for more information
• Anticoagulants
  • Medications, such as warfarin and heparin, also interfere with the blood's ability to form clots by acting on a different chemical process in the body.

Clot busters (tPA)

• For ischemic strokes, tPA (tissue Plasminogen Activatoris) a FDA-approved clot busting drug.
• tPA must be given within three hours from the onset of symptoms.
• tPA Fact Sheet (Danbury Hospital)
• Genentech/Activase (tPA manufacture; local rep: Pat McCormick, Clinical Specialist, 919-349-0540 or mccormick.patricia@gene.com).

Carotid Endarterectomy

• The Carotid arteries, located in the neck region, supply blood to the brain and are located in the neck
• Carotid Endarterectomy is a surgical procedure which removes a blockage from the carotid artery
• Blockage is most commonly due to atherosclerosis (the "hardening of the arteries") caused by the too much fatty deposits, cholesterol, and other materials in the artery.

Angioplasty & Stents

• Angioplasty and stenting are surgical procedures to re-open blocked arteries. In angioplasty, a tiny balloon is used to compress the buildup in the artery. Once the artery is re-opened a small mesh-metal stent may be placed in the artery to prevent future damage.
• See a detailed animation of Carotid Stenting

Hemorrhagic Stroke Treatment

• Surgical Intervention
  • Placing a metal clip at the base of the aneurysm or removal of abnormal bloods vessels.
• Endovascular Procedures
  A less invasive procedure that uses a catheter (through a major arm or leg vessel) to guide a mechanical agent, such as a coil (Merci device), to the aneurysm to prevent rupture.

Educational Resources

• Let's Talk about Diagnosis (American Heart Association)
  • A 2-page handout describing the different types of tests used to diagnosis a stroke.
  • Available in Spanish as well.
• Patient's Guide to Carotid Endarterectomy and Carotid Angioplasty (Memorial Health Systems)
  • A 26-page guide describing the procedure (before, during and after) and benefits and risks for the procedures.
• EAHEC Annual Regional Stroke Conference

Clinicians, please see more diagnosis and treatment resources at the Quality Improvement page and/or Continuing Education page.