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Diagnosing and Treating Ischemic Stroke

Making a Diagnosis

In order to make a diagnosis of ischemic stroke, a healthcare provider will begin by asking a number of questions (such as those concerning the patient's medical history) and perform a physical exam. If the healthcare provider believes that a person has had a stroke, he or she may order additional tests. After doctors have diagnosed an ischemic stroke, they may recommend certain other stroke tests to help determine what caused the stroke.
 
Some tests that doctors use to diagnose an ischemic stroke and/or identify its cause include:
 
  • CT scan
  • Magnetic resonance imaging (MRI)
  • Carotid Doppler ultrasound
  • Carotid arteriography
  • Cerebral angiography (also known as a cerebral angiogram, cerebral arteriogram, or digital subtraction angiography)
  • Magnetic resonance angiogram (MRA) or functional magnetic resonance imaging (fMRI)
  • Transcranial Doppler
  • Electrocardiogram (EKG)
  • Echocardiogram
  • Lumbar puncture
  • Electroencephalography (EEG).
     
(Click Diagnosing Stroke for more information on diagnosing stroke. See Stroke Tests for more information on the tests for stroke listed above.)
 

Treating an Ischemic Stroke

Delaying treatment can result in lasting damage to your brain, or even death. The sooner stroke treatment begins, the better your chances of recovering.
 
The main goal of ischemic stroke treatment is to quickly restore blood flow to the brain. Restoring blood flow to the brain is vital to prevent or limit damage to the brain tissue and to prevent another stroke. Brain cells die quickly when they do not receive oxygen- or nutrient-rich blood. In most cases, doctors treat an ischemic stroke with thrombolytic drugs to help restore blood flow.
 
Healthcare providers administer thrombolytic ("clot-busting") drugs to dissolve blood clots that are blocking blood flow to the brain. When received soon after an ischemic stroke begins, these drugs can limit or prevent permanent damage to the brain by dissolving the blood clot. In treating an ischemic stroke that has just occurred, every minute counts. If a person is exhibiting stroke symptoms, get him or her to a hospital as soon as possible to be evaluated and receive treatment.
 
A thrombolytic drug known as tissue plasminogen activator (t-PA, Activase®) can be effective for stroke treatment if a person receives it within three hours after his or her stroke symptoms have started. Because thrombolytic drugs can increase bleeding, doctors only use t-PA after they are certain that the person has suffered an ischemic stroke and not a hemorrhagic stroke.
 
In addition to treatments to restore blood flow in people who have suffered an ischemic stroke, healthcare providers may recommend other medications or therapies as part of stroke treatment to reduce complications or the chances of another stroke. Some of these medicines can include:
 
  • Anticoagulants
  • Antiplatelets.
     
(Click Stroke Treatment for more information on these medicines and other stroke treatments.)
 
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