How Is a Stroke Diagnosed?

A stroke results from the disruption of blood flow to the brain.1 There are two main types of stroke, ischaemic and haemorrhagic, while there is a third more minor stroke called a transient ischaemic attack (TIA). An ischaemic stroke can be caused by a blood clot that formed in the heart and travelled to the brain or by atherothrombosis. Conversely, haemorrhagic strokes are caused by a rupture in the blood vessels, resulting in bleeding within the brain. A TIA is a blood clot that temporarily interrupts blood flow in the brain and is a risk factor for future strokes that could cause more serious damage.1,2


Ischaemic strokes can be classified into embolic strokes and atherothrombotic strokes. Embolic strokes occur when a blood clot forms in another part of the body such as the heart (in atrial fibrillation) and travels to the brain causing damage.2 In contrast, atherothrombotic strokes result from the build-up and rupture of fatty deposits in the arteries in the brain, which cause the formation of blood clots.2


A haemorrhagic stroke can be caused by a bulge in a brain artery or a weakened blood vessel that ruptures causing it to bleed and that part of the brain to swell, resulting in damage to the cells and tissues in the brain. Haemorrhagic strokes account for about 13% of all strokes.2,3


Ischaemic strokes are the most common type of stroke, accounting for more than 87% of all strokes.2 Factors contributing to stroke risk include unhealthy lifestyles such as smoking, high-calorie diets, low levels of exercise and drinking.

What is Atrial Fibrillation? This article examines irregular heartbeat, which is a symptom of atrial fibrillation. Read more

A diagnosis of stroke requires both physical tests and brain scan images at the hospital to confirm and ascertain how to proceed with treatment. Physical tests also include taking blood samples to check for cholesterol and glucose levels, and your pulse for an irregular heartbeat or taking a blood pressure measurement. Swallow tests are essential for anyone who has had a stroke, because swallowing ability is commonly affected early after having a stroke. A brain scan will also be performed to ascertain what type of stroke has occurred, because ischaemic and haemorrhagic strokes have different appearances. A computed tomography (CT) scan will be performed to ascertain a diagnosis of either ischaemic or haemorrhagic stroke. Everyone suspected of having a stroke should receive a brain scan within an hour of arriving at the hospital. The earlier the brain scan, the more likely the patient is to derive benefit from a clot-busting drug (thrombolytic), such as alteplase, or anticoagulant medication.6


Whether an ischaemic stroke or a haemorrhagic stroke has occurred, a diagnosis will help to determine the best course of action for treating the stroke.7

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