Diagnosis of ischemic stroke is carried out as follows:
The first CT scan is carried out, as it is in almost all cases to distinguish hemorrhage from infarction. However, hemorrhagic infarction (heart attack bleeding in the area) are not always detected.
Magnetic resonance tomography - even more sensitive method of diagnosing a heart attack at an early stage. However, it is inferior to CT in detecting acute bleeding, and therefore less suitable for emergency diagnosis. Magnetic resonance angiography allows to obtain images of the brain, it is not as sensitive as conventional angiography, but the non-invasive and therefore more secure.
Lumbar puncture. If there is no way to CT and MRI, the study provides valuable information to the CSF, since the majority of patients with intracerebral hemorrhage and in all cases of subarachnoid hemorrhage in the cerebrospinal fluid can detect blood. In ischemic stroke, blood in the cerebrospinal fluid is not detected.
The study of the carotid arteries. To do this, held ultrasonic diagnostic methods - Doppler and duplex scanning. The most informative duplex scanning, which combines the visualization of the carotid arteries and Doppler blood flow in them. A new ultrasound technique - transcranial Doppler study - allows you to indirectly assess blood flow velocity in intracranial arteries of some. With this method it is possible to identify stenosis of intracranial arteries, but it is especially useful in the diagnosis of spastic cerebral arteries in subarachnoid hemorrhage.
Cerebral angiography - the most reliable method of diagnosis, is almost indispensable if you plan an operation. In experienced hands, the likelihood of complications is low, especially when using access through the femoral or brachial artery. However, there is always the risk of stroke or damage to the artery catheter, so that angiography should be used strictly on the evidence, and only in cases where it is impossible without the treatment planning. The method consists in the fact that access to the femoral artery in the groin crease, entered a long, thin catheter that reaches the mouth of the carotid arteries. More over it is introduced into the blood contrast agent, and conducted a series of x-rays.
In addition to these methods in the diagnosis of ischemic strokes play a role, methods such as electroencephalography, scintigraphy, positron emission tomography and single photon emission tomography and laboratory tests.
