Diagnostic tests Blood test: complete blood count(CBC), platelet and clotting studies, erythrocytes sedimentation rate (ESR),

metabolic panel, such as renalytes and glucose Computed tomography(CT) scan with or without enhancement: Demonstrate structural abnormalities and presence of edema, hematoma, ischemia, and infarction.

Purpose Various laboratory studies may be done to rule out systemic causes of stroke

Magnetic Resonance imaging (MRI): demonstrate structural abnormalities and presence of edema, hematoma, ischemia and infarction. Positron emission tomography(PET) scan demonstrate adequacy of cerebral blood flow and metabolism Cerebral Angiography procedure that uses X-ray and opaque dye to help identify abnormalities of the blood vessels within the brain Transcranial Doppler Ultrasonography: Evaluate the velocity of blood flow through major endocranial vessels Lumbar Puncture (LP) with cerebrospinal fluid (CSF) Analysis: Measures intracerebral pressure. Collected fluid analysis assist in diagnosis of cause of CVA

May not immediately reveal all changes. Ischemia infarction may not may not evident for 8-12 hours after event. Hemorrhagic events are evident immediately; therefore, emergency CT scan is done prior to administration of thrombolytics. Normal CT scan with the a TIA. May show evidence of stroke within minutes of occurrence and especially beneficial for assessing smaller strokes deep within the brain Abnormal in ischemic event

Stroke Scale: A standardized instrument measuring multiple factors, including LOC, motor and sensory responses, and language, on a numeric scale overtime X-ray (SKULL), Evaluates internal structure of brain.

Helps to determine specific cause of stroke such as hemorrhage or obstructed artery and pinpoint site of occlusion or rupture. Identifies problems with circulation, such as diminished blood flow or presents of arterosclerotic plaques. Pressure is usually normal and CSF is clear in cerebral thrombosis, embolism, and TIA. Pressure elevation and grossly bloody fluid suggest subarachnoid and intracerebral hemorrhage. CSF total protein level maybe elevated in cases of thrombosis because of inflammatory process. LP should be performed if septic embolism from bacterial endocarditis is suspected. The higher the score, the more severe stroke symptoms.

Electrocardiogram (ECG), or Echocardiogram: May be done to rule out cardiac origin as a source of embolus.

May show shift of perineal gland to the opposite side from an expanding mass: Calcification of the internal carotid may be visible in cerebral thrombosis; Partial calcification of walls 20% of stroke as the result of atrial fibrillation or emboli associated with valvular disease, dysrhythmias, or endocarditis.