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Stroke treatment: Tests

  • Many tests are used to find the cause(s) of the stroke, measure how bad the stroke is and make decisions about how to treat it. You may have one of more of the following tests.

    Blood tests

    These are used to look for stroke risk factors or conditions that may have led to the stroke. Blood tests are done to look at:

    • your cholesterol or triglyceride levels
    • how your blood clots, such as partial thromboplastin time (PTT) or international normalized ratio (INR)
    • if you have diabetes (blood glucose levels)
    • if you have vasculitis (swelling of your scalp vessels or brain blood vessels)
    • the level(s) of medicine in your blood.

    Swallow tests

    These tests are done to find out what is causing your problems with swallowing, moving your mouth, coughing or choking on food or drinks.

    • at your hospital bed: A speech-language pathologist will watch you eat foods and drink liquids. This will help tell if other tests are needed, or what foods and liquids are safest for you.
    • video swallow: You will swallow some barium (a white liquid that shows up on X-ray) to simulate "normal" eating. A video X-ray is taken as you swallow the barium. A radiologist and speech-language pathologist can study your ability to swallow. He or she will check for aspiration (if food and liquids are going into your wind pipe).

    Imaging tests

    These are done to find the area of the brain affected by the stroke, make an early prognosis and rule out other medical conditions.

    • CT or CAT scan (computerized axial tomography): This scan uses X-ray and computer to get an in-depth look at your brain. A CT scan will be done to rule out hemorrhage (bleeding) as the cause of the stroke.
    • MRI scan (magnetic resonance imaging): The MRI uses a magnetic field to get a 3-D view of your organs. This scan can give information about your tissues and blood flow. If you have a pacemaker or if you have metal fragments in your head, you may not be able to have this scan.
    • Ultrasound: This painless, safe test uses high-frequency sound waves to create an image of your arteries and blood flow on a computer screen. This lets your doctor see if your arteries are narrowed or damaged. Carotid or doppler ultrasound is most often done on the carotid arteries in your neck.
    • Trans cranial doppler (TCD or cranial ultrasound): This is similar to the carotid ultrasound. It is a test that measures blood flow through the major vessels in the brain.
    • Magnetic resonance angiogram (MRA) and CT angiography: These are tests that use standard MRI or CT technology to get a 3-D view of your blood vessels.
    • Angiogram: This uses X-ray to see your blood vessels. A radiologist (doctor of X-ray) inserts a tube (catheter) in an artery in your groin and threads it to the arteries in your neck and head. He or she injects dye into your blood vessels to help them show up on the X-ray. This test also helps rule out problems with blood vessels in the neck or brain.

    Heart tests

    Heart problems can be linked to strokes. You are at risk of stroke if you have atrial fibrillation (irregular heartbeat), have had a heart attack or if you have an artificial heart valve.

    There are five tests used to check your heart.

    • Electrocardiogram (EKG): This test records the electrical activity of your hear through small patches (electrodes) on your chest. By looking at "waves" on a computer monitor, your doctor can tell if you have had a heart attack, irregular heartbeat or other heart problem.
    • Blood tests: Certain enzymes and proteins are released when your heart is damaged. Your doctor can use these tests to tell if you had a heart attack.
    • Echocardiogram (echo): This is a study of your heart, valves and the aorta (the main artery leaving the heart). A wand-like transducer makes sound waves. The technician moves the wand over your chest, and sound waves create pictures of your heart on a screen. This lets your doctor see how well your valves are working. He or she may also see if you have a blood clot near your heart.
    • Transesophageal echocardiogram (TEE): A doctor has you swallow a flexible tube into your esophagus. The tube has a small wand-like transducer at the end. This is similar to the regular echocardiogram but it can look at deeper areas of the heart.
    • Contrast echo (bubble study): A doctor injects a small number of bubbles through a vein into your heart. This will let him or her see if there is an abnormal opening between the right and left sides of your heart.
  • Source: Allina Health Patient Education, Understanding Stroke: Information about Stroke and Recovery, fourth edition, ISBN 1-931876-13-4
    Reviewed by: Allina Health Patient Education experts
    First published: 02/01/2006
    Last reviewed: 12/09/2011