Stroke diagnosis

Am I having a stroke?

You might be having a stroke, or a mini-stroke, if you experience one or more of the following symptoms:

• Numbness or muscle weakness, usually on one side of the body
• Difficulty speaking or understanding speech
• Dizziness or loss of balance
• Double vision or difficulty seeing in one or both eyes

The symptoms of a mini-stroke might only last for a few minutes, but these symptoms are early warning signs of a major stroke. The risk¹⁴ of stroke is especially high within 48 hours after a mini-stroke. Call 911 right away if you suspect that you’ve had a stroke, even if the symptoms have gone away.

Once you get to the hospital¹⁵, your emergency team will quickly try to determine what type of stroke you had or are currently experiencing. You'll likely have a CT scan or other imaging test soon after arrival. Providers also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction.

Some of the tests you may have include:

• A physical exam: Your provider will do a number of tests you're familiar with, such as listening to your heart and checking your blood pressure. You'll also have a neurological exam to see how a potential stroke is affecting your nervous system.
• Blood tests: You may have several blood tests, including tests to check how fast your blood clots, whether your blood sugar is too high or low, and whether you have an infection.
• 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 in the brain, an ischemic stroke, a tumor, or other conditions. The provider 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 provider 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 any buildup of fatty deposits (plaque) and the blood flow in your carotid arteries.
• Cerebral angiogram: In this uncommonly used test, your provider 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. Your provider then 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 to your brain and caused your stroke.