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Diagnosis Of Ischemic Stroke

The diagnosis of an ischemic stroke depends on what the clinical situation is that the physician encounters initially. It may be appropriate to do tests such as an emergency CT or MRI scan. However, the most important step initially is the stabilization of the patient.

Then it depends on many factors what the physician will do next. For instance, if the patient has an advanced age (80 years or more) there might not be any merit in further testing as further interventional therapy is rarely indicated. This age group of patients has a guarded prognosis and any heroic measure tends to only increase the mortality, so that this group of patients might be best just treated conservatively. On the other hand, younger patients would benefit greatly from plasminogen activator (TPA or tissue plasminogen activator), but this can only be given, if it is known that there is no sign and no danger of a hemorrhagic stroke.

Reference 1 shows that a triphasic perfusion CT scan (= perfusion CT; thanks to for this link) is such a tool to exclude hemorrhagic stroke safely before tPA is given intravenously.

 Diagnosis Of Ischemic Stroke (CT Scan Of Brain)

Diagnosis Of Ischemic Stroke (CT Scan Of Brain)

An electroencephalogram (EEG) is done, if seizures were part of the symptoms. The physician may decide to add a toxicology screen and a blood alcohol level to rule out substance abuse.



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14. : Zhang Y, Tuomilehto J, Jousilahti P, Wang Y, Antikainen R, Hu G. Lifestyle factors on the risks of ischemic and hemorrhagic stroke. Arch Intern Med. 2011 Nov 14;171(20):1811-8. Epub 2011 Sep 12.

15.  David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

Last modified: October 22, 2014

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.