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It is now
possible to examine how the brain looks, functions and
gets its blood supply. These tests can outline the
affected part of the brain and help define the problem
created by stroke. Most of these tests are safe, painless
and can be done as an outpatient. A doctor must decide on
a case-by-case basis whether such tests will be useful,
and if so, which ones to use.
Some of the Tests useful in the
investigation of Stroke
Computerized axial tomographic scan (C.T. or CAT scan)
Magnetic resonance imaging scanning (M.R.I.)
Radionuclide angiography
Electroencephalogram (E.E.G.)
Evoked response test
Doppler ultrasound test
Carotid phonoangiography
Digital subtraction angiography (D.S.A.)
- Computerized
axial tomographic scan (C.T. or CAT scan)
- Imaging procedure that uses x-rays to generate
an image of the brain. Doctors use CT to
determine whether a stroke has occurred and to
identify the type of stroke: ischemic (result of
blockage) or hemorrhagic (result of bleeding).
- Magnetic
resonance imaging scanning (M.R.I.)
- In this imaging procedure, the patient is
placed in a magnetic field, causing a change in
the behavior of the cells in the brain. Once the
patient is in a magnetic field, the head is
subjected to bursts of energy of a known
frequency. The response of the brain cells to
these bursts of energy is detected in the form of
signals that ultimately generate the image of the
brain. MRI can provide very accurate images of
the brain and is used to determine the presence,
location and size of aneurysms and arteriovenous
malformations, which are potential sources for
hemorrhagic stroke.
- Radionuclide
angiography - An imaging procedure where
radioactive compounds are injected into a vein in
the arm and allowed to be carried in the
bloodstream toward the head. As the radioactive
compound circulates in the bloodstream, it is
constantly emitting bursts of radiation. Once the
radioactive compound reaches the brain, these
bursts of radiation are detected by a special
detector and used to form an image of the brain.
This imaging procedure can detect blocked blood
vessels and areas where the brain has been
deprived of blood flow and is damaged.
- Electroencephalogram
(E.E.G.) - In this diagnostic procedure,
small metal disks (electrodes) are placed at
strategic locations on a person's scalp. The
electrodes can detect the electrical activity in
the form of impulses that are then transcribed to
paper. By observing the characteristics of the
impulses such as intensity (how large in the
impulse), duration (how wide is the impulse),
frequency (how often do impulses occur during a
given time) and location (what region of the
brain is producing these impulses), an EEG can
provide valuable information about underlying
problems in the brain.
- Evoked
response test - A diagnostic procedure
that provides a measurement of the brain's
ability to process and react to different sensory
stimuli. A doctor evokes a visual response by
flashing a light or checkerboard pattern in front
of a patient. For auditory evoked responses, a
doctor produces a sound in one of the patient's
ears. For bodily evoked responses, one of the
nerves in an arm or leg is electrically
stimulated. The responses from either of these
sensory stimuli can indicate abnormal areas of
the brain.
- Doppler
ultrasound test - In this imaging
procedure, ultrasound or high-frequency sound
waves are used to detect blockages in the carotid
artery . A Doppler probe or instrument capable of
generating ultrasound waves is placed on the
neck, very close to the carotid artery.
Ultrasound waves generated from the probe travels
through the neck and bounces off the moving blood
cells. The reflected sound wave, now returning to
the probe at a different frequency, is then
detected by the same probe. The change in
frequency of the sound waves is related to the
speed of the blood cells and hence the blood
flow.
- Carotid
phonoangiography - In this diagnostic
procedure, a sensitive microphone is placed on
the neck, very close to the carotid artery, to
record generated sounds. Ordinarily, in a normal
artery, blood flows in a smooth and controlled
manner. However, the presence of blockages, such
as those caused by atherosclerosis, disrupt the
controlled nature of blood flow, causing the
blood flow to become turbulent. The turbulent
blood flow can create a sound, called a bruit ,
that can be detected and registered by the
microphone. The presence of a bruit indicates a
blockage in the carotid artery and is cause for
further investigation.
- Digital
subtraction angiography (D.S.A.) - In
this imaging procedure, a contrast dye is
injected into a vein in the arm and allowed to
circulate in the bloodstream. Once the dye
reaches the brain, an x-ray machine quickly takes
a series of images or pictures of the head and
neck. The images track the movement of the
contrast dye as it proceeds through the blood
vessels of the brain. This imaging technique
allows the doctor to identify and localize the
source of stroke, whether it be ischemic (result
of blockage) or hemorrhagic (result of bleeding
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