If you're experiencing stroke symptoms, getting to a highly specialized treatment center that can quickly diagnose and deliver individualized treatment can have a dramatic impact on your outcome.
At Mayo Clinic, the nation's leading neurosciences team of emergency stroke experts will quickly evaluate the type of stroke you're having and the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Your care team will likely use several tests to immediately determine your risk of stroke, including:
Examination. Your doctor will ask you or a family member what symptoms you've been having, when they started and what you were doing when they began. Your doctor then will evaluate whether these symptoms are still present.
Your doctor will want to know what medications you take and whether you have experienced any head injuries. You or your family member may be asked about your personal and family history of heart disease, transient ischemic attack or stroke.
Your doctor will perform a detailed neurological and medical examination. This includes checking your blood pressure and using a stethoscope to listen to your heart and to listen for a whooshing sound (bruit) over your neck, which may indicate hardening or narrowing (atherosclerosis) of the carotid arteries. Your doctor may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or clots in the blood vessels at the back of your eyes.
- Blood tests. You may have several blood tests, which tell your care team how fast your blood clots, whether your blood sugar is abnormally high or low, whether critical blood chemicals are out of balance, or whether you may have an infection. Care providers will manage your blood's clotting time and levels of sugar and key chemicals as part of your stroke care.
- Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed image of your brain. A CT scan can show bleeding (hemorrhage), tumors, strokes and other conditions. Doctors may inject a dye into your bloodstream to view your blood vessels in your neck and brain in greater detail (computerized tomography angiography).
- Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of your brain. An MRI can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiography, or magnetic resonance venography).
- Carotid ultrasound. In this test, sound waves create detailed images of the inside of the carotid arteries in your neck. This test shows buildup of fatty deposits (plaques) and blood flow in your carotid arteries.
- Cerebral angiogram. For this test, your doctor inserts a thin, flexible tube (catheter) through a small incision, usually in your groin, and guides it through your major arteries and into your carotid or vertebral artery. Then your doctor injects a dye into your blood vessels to make them visible under X-ray imaging. This procedure gives a detailed view of arteries in your brain and neck.
Echocardiogram. An echocardiogram uses sound waves to create detailed images of your heart. An echocardiogram can find a source of clots in your heart that may have traveled from your heart to your brain and caused your stroke.
You may have a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots.
Mayo Clinic subspecialized experts conduct these tests and immediately collaborate with each other to provide accurate diagnoses and timely treatment strategies individualized for each patient.