Stroke - Diagnosis & Treatment

How is stroke diagnosed?

Diagnostic tests for a stroke include:

• Physical examination. Your doctor will ask about your medical history, and check your alertness, blood pressure, vision, reflexes, coordination and muscle strength.
• Blood tests. These are performed to check blood glucose and cholesterol levels, identify blood clotting factors, and detect infections.
• Computed tomography (CT). A CT scan of the brain helps to detect bleeding, an ischaemic stroke, a tumour or other medical conditions.
• Magnetic resonance imaging (MRI). It uses magnetic and radio waves to develop detailed images of the brain to see damaged brain tissues.
• Cerebral angiogram. This is performed to get a clear image of the blood vessels in the brain and neck.
• Carotid ultrasound. This detects fatty deposits in carotid arteries (in the neck) that supply blood to the brain and face.
• Echocardiogram. Sound waves are used to create images of the heart to find clots in that may have dislodged and travelled to the brain.

How is stroke treated?

Depending on the type of stroke that occurred, and the time treatment is being sought, your doctor may recommend different treatment methods:

Treatment for ischaemic strokes

It is not possible to repair the brain damage caused by a stroke, but there are ways to minimise the injury.

Treatment methods for ischaemic strokes include thrombolysis and thrombectomy to enable clot-removal:

• Thrombolysis uses medications to dissolve the blood clot, and needs to be administered within 4 and a half hours of experiencing acute stroke symptoms.
• Thrombectomy uses a clot retrieval device to extract the blood clot. The process involves the insertion of the device into an artery in the groin, and moving it towards the brain to extricate the blood clot. It should be done within 6 hours from the onset of stroke symptoms.

Treatment for haemorrhagic strokes

Immediate emergency care is critical for haemorrhagic stroke.

Treatment methods primarily focus on medications or surgeries to stop or control the bleeding, and to reduce pressure on the brain.

In some cases, a neurosurgeon may perform a surgical procedure known as craniotomy to open up the skull to remove blood and relieve pressure on the brain. This surgery can also help to repair blood vessel problems that results in hemorrhagic strokes.