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  • Slider-Image-Stroke
    STROKE
    Learn about the role of laboratory testing in the diagnosis and treatment of Stroke.

WHAT IS A STROKE?

A stroke, also known as a cerebrovascular accident (CVA), occurs when something disrupts blood flow to the brain. Depending on the region of the brain affected, a stroke can cause a variety of neurological symptoms. There are two major types of strokes: ischemic stroke and hemorrhagic stroke.

An ischemic stroke happens when a blood clot blocks blood vessels supplying the brain. The clot acts like a plug and stops further blood flow to the brain. This leads to loss of oxygen and nutrients to a specific region of the brain.

A hemorrhagic stroke, also known as an intracerebral hemorrhage, occurs when one of the small blood vessels in the brain bursts or ruptures. About 15% of all strokes are hemorrhagic strokes. Some blood vessels in the brain are more likely to burst. Hemorrhagic strokes usually affect the parts of the brain around these vessels. Unlike an ischemic stroke, during a hemorrhagic stroke a blood vessel is not blocked or clogged. However, the rupture of the blood vessel leads to loss of oxygen and nutrients to part of the brain.

 

 

RESOURCES

Educational Materials: Stroke

 

ISCHEMIC STROKE VS. HEMORRHAGIC STROKE

Ischemic Stroke on the left: Blood clot blocks blood flow to part of the brain

Hemorrhagic Stroke on the right: Artery ruptures, causing bleeding in or around the brain

COMMON SIGNS AND SYMPTOMS OF STROKE

Stroke symptoms may include sudden weakness of arms and legs on one side, facial weakness, double vision, difficulty walking, and difficulty speaking.

It's challenging to identify whether a stroke is ischemic or hemorrhagic based only on symptoms. However, hemorrhagic stroke is more likely to cause a sudden and continuous headache. These headaches are caused by blood building up in the brain and causing increased pressure on the brain.

 

BE FAST is an acronym that can help quickly identify symptoms of a stroke

LABORATORY TESTS RELATED TO STROKE

Complete Blood Count (CBC): This test helps examine overall blood count levels, including red blood cells, white blood cells, and platelets. A CBC can quickly inform doctors of potential contributors to stroke, identify illnesses that may contribute to stroke, and provide input into management of stroke.

Basic Metabolic Panel (BMP): This blood test measures the status of a patient’s metabolism, including glucose, electrolytes, kidney function, and fluid balance. This test is important because the body tightly regulates its physiology, and these values can indicate when there is a problem. Results from a BMP can help doctors rule out other conditions. They can also help to identify illnesses that may contribute to stroke.

Coagulation Tests: These are laboratory tests that assess the body’s ability to form and remove blood clots. Some more common coagulation tests are prothrombin time (PT), activated partial thromboplastin time (aPTT), and INR (international normalized ratio). These tests all measure how long it takes for the blood to clot. Abnormalities in these tests may guide doctors towards potential causes of stroke and aid in the acute (short term) management of stroke. Patients who have an ischemic stroke often have a faster than normal clotting time. Patients who have hemorrhagic stroke often have a slower than normal clotting time.

Cardiac Biomarkers: This is a set of laboratory tests that evaluate the function of the heart. Abnormalities in these tests may guide the diagnosis and have implications for the outcome, or prognosis, of stroke. Cardiac biomarkers that may be elevated in stroke include troponins, creatine kinase-MB, and brain natriuretic peptide (BNP). These biomarkers are proteins that are mostly found in heart muscle. These may also be used for prognosis in stroke patients.

ADDITIONAL TESTS AND IMAGING TO UNDERSTAND STROKE

Oxygen Saturation: Oxygen saturation is a way to check how much oxygen is in a patient’s blood. Oxygen saturation is usually measured during a bedside evaluation of stroke using a tool called a pulse oximeter. Abnormal oxygen saturation can be a sign of ischemic stroke. For most people, normal blood oxygen is between 90% and 100%.

EKG/Electrocardiogram: This test evaluates how well the heart is working by recording the electrical signals of the heart. The machine is portable, and an EKG can be performed in most hospital rooms. Abnormalities in EKG patterns can help determine what is causing a stroke.

CT Scan of Head: This is a type of radiologic examination that combines x-rays from multiple angles to create an image of the brain. A CT scan can be used to distinguish between ischemic and hemorrhagic stroke, to identify the region of the brain impacted by the stroke, and to identify any potential consequences of the stroke that may require surgical intervention.

MRI of Brain: This is also a radiologic examination of the brain, but it provides more detail than a CT scan. Certain types of MRI are more sensitive and can more reliably detect blood flow abnormalities. These types of MRIs are often used in addition to a CT scan to understand the effect of stroke.

 

Questions To Ask Your Doctor

  • What is a stroke?
  • How did this happen?
  • What is the outcome in my case?
  • What risk factors do I have for stroke?
  • Are there laboratory tests I should get to monitor potential risk factors?
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