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Understanding & Diagnosing Stroke

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Strokes are the fifth leading cause of death in the US today, and a principal cause of all disability in adults. Yet many people don?t really know what a stroke is or how to recognize the signs of a stroke, even though understanding the early signs and symptoms could save your life or that of a loved one.

A stroke occurs when the blood flow is cut off to part of the brain. This deprives brain cells of oxygen and they start to die. A stroke can cause permanent loss of movement, speech, and/or memory and cognitive skills.

Symptoms of Stroke

  • Difficulty speaking or understanding others.
  • Numbness or paralysis of the face, an arm, and/or a leg ? usually on only one side.
  • Problems with balance, coordination, or the ability to walk.
  • Trouble seeing through one or both eyes.
  • Sudden, severe headache.

How is Stroke Diagnosed?

To determine the best treatment for a stroke, the emergency medical team first has to identify the type of stroke and the parts of the brain that are affected. In addition, they have to rule out other potential medical problems which could be causing the symptoms, such as a drug or brain tumor. They may use one or more tests to determine the type and cause of the stroke, including:

  1. Physical Examination. A doctor needs to find out exactly what symptoms are present, when they began, and what the patient was doing when they started, as well as if these symptoms are still present. They need to check the patient?s blood pressure and listen to their heart for a bruit, a whooshing sound through the carotid arteries in the neck that may indicate atherosclerosis. The doctor may also check the patient?s eyes with an ophthalmoscope for tiny cholesterol crystals or clots in the blood vessels in the back of the eyes.
  2. Medical History. The doctor will need to know all medications the patient is taking and whether they have experienced any head trauma. Any personal or family history of heart disease, transient ischemic attack, or stroke is also important.
  3. Blood Tests. The doctor will probably conduct blood tests to find out how quickly the patient?s blood clots, if their blood sugar is abnormally low or high, whether any blood chemical levels are abnormal, or if an infection is present.
  4. Computerized Tomography (CT) Scan. A CT scan is a sequence of X-rays that is used to create a detailed picture of the brain. CT scans can show a brain hemorrhage, tumor, stroke, or other condition. The patient may be injected first with dye in order to better see the blood vessels in the neck and brain using computerized tomography angiography.
  5. Magnetic Resonance Imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of the brain. MRIs can detect brain tissue that has been damaged by an ischemic stroke causing brain hemorrhages. The doctor may also inject a dye into a blood vessel to better see the veins and arteries so they can follow the blood flow using a magnetic resonance angiography, or a magnetic resonance venography.
  6. Carotid Ultrasound. A carotid ultrasound uses the power of sound waves to create detailed images of the inside of the carotid arteries in the patient?s neck. It can show the buildup of fatty deposits, called plaques, and the blood flow through the carotid arteries.
  7. Cerebral Angiogram. This procedure involves inserting a thin, flexible tube, or catheter, through a small incision in the patient?s groin that is then guided through their major arteries up into the carotid or vertebral artery. The doctor then injects a dye into the blood vessels to make them visible using X-ray imaging. This test provides a detailed view of the arteries in both the brain and neck.
  8. An echocardiogram uses sound waves to create detailed images of the patient?s heart. This test can find the source of any clots in the heart that may have traveled from the heart to the brain, causing a stroke. In a transesophageal echocardiogram, the doctor inserts a flexible tube with a small device called a transducer that is attached to the patient?s throat and maneuvers it down into the esophagus. This test can create clear, detailed ultrasound images of the heart and any blood clots that may be present.

Each year almost 185,000 people die from strokes and nearly seven million become stroke survivors, often left with varying degrees of disability. If you or someone you love has suffered from a stroke, specialized in-home care may be required. Luckily, the staff of Specialty Care has experience in helping families cope with the aftermath of stroke. Contact us 24/7 for more information today.

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