Stroke Diagnosis & Treatment

How is stroke diagnosed?

Physical exam. Your doctor will perform a physical exam to rule out any other conditions, and will measure your blood pressure and listen to your heartbeat to check for a "whooshing" sound over your carotid arteries, located in the neck. If present, this sound can indicate the presence of plaque buildup within the walls of the heart's arteries. Your doctor might also inspect your eyes to look for signs of tiny clots in the blood vessels at the back of your eyes.

Blood tests. Blood tests can reveal how quickly your blood clots, measure levels of blood sugar and other key chemicals, and identify an infection. Managing these components will be important to your stroke care.

Carotid ultrasound. This test uses sound waves to created detailed images of the inside of the carotid arteries in the neck, which can reveal plaque buildup and decreased blood flow.

Echocardiogram. Similar to an ultrasound, an echocardiogram uses sound waves to create detailed images of the heart, which help providers identify the clots in your heart that may have traveled to your brain and caused a stroke.

Cerebral angiogram. With the help of biplane interventional imaging, a small tube called a catheter is inserted into a major artery (typically, in the groin) and guided through the arteries in the heart up to the brain.

Biplane imaging technology produces detailed 3-D images of the structure and location of blood vessels, soft tissues and blood flow in real-time, enabling providers to identify a clot or hemorrhage and evaluate its condition.

CT scan (computerized tomography). A CT scan uses a series of X-rays to create detailed, 2-D images of the brain. Contrast dye is often injected into the blood vessels to help highlight blood flow throughout different areas of the brain, better enabling providers to detect any abnormalities. When dye is used to assist in this type of scan, the variation is called a CT angiogram.

MRI (magnetic resonance imaging). An MRI renders intricate images of the brain, utilizing powerful magnets and radio waves, rather than radiation, to produce 2-D and 3-D images of the soft tissue.

Compared to a CT scan, MRI technology can show more subtle changes in brain tissue and a more precise location of any malformation and related bleeding, which is helpful in diagnosing a stroke.

Treatment Options

It's critical to restore blood flow to the brain as quickly as possible after an ischemic stroke.

EvergreenHealth's specialized stroke team is available 24/7 to administer leading-edge medications, blockage treatments and, when necessary, neurosurgery.

Clot-busting medication. If appropriate, you might be given clot-busting medication such as tPA (tissue plasminogen activator). These drugs must be administered within three hours of the onset of symptoms in order to most effectively dissolve the clot and reverse the symptoms.

Read about Gary Fujioka's recovery using tPA

Biplane imaging technology. Biplane imaging uses two rotating cameras to produce detailed 3-D images of blood vessels, soft tissue and blood flow in real-time. Physicians can then use the detailed images to help guide minimally invasive procedures to diagnose and treat blockages, aneurysms or blood clots in the brain – essentially combining diagnosis and treatment into one procedure.

For stroke patients, this technology allows providers to physically open blood vessels and remove clots, restoring blood flow to the brain. When every minute counts, being able to receive a neurological exam immediately after the onset of symptoms can make all the difference in recovery.

Additionally, our experts can use biplane interventional imaging to perform a thrombectomy, an endovascular procedure in which a catheter is inserted through a main artery in the groin and guided up to the brain. Attached to the catheter is a stent or other device, which the physician maneuvers into the blocked blood vessel to trap and remove the clot. This procedure should be performed within six hours of the onset of systems, and is often performed in combination with administering tPA medication to dissolve larger clots.

Neurosurgery. If a stroke is due to bleeding in the brain, neurosurgeons are available 24/7 should surgical intervention be called for.