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Investigations after a stroke

images illustrating investigations you may have after a stroke

Brain scans

A brain scan will be performed within 24 hours of symptom onset upon recognition of or suspecting a stroke. It is undertaken immediately if necessary.

  • A CT/CAT(computerised axial tomography) scan is best described as a form of X-ray of the brain.
  • MRI scans (magnetic resonance imaging) are taken in a large tunnel-shaped scanner. This will take longer than a CT scan and produces some noise whilst the pictures are taken. Not every patient will be suitable or need an MRI.

Heart and blood vessel tests

Tests on the heart and blood vessels may be carried to confirm the cause of stroke. These include:

  • A carotid doppler test using ultrasound measures the speed of blood flow in the carotid arteries of the neck, this test is carried out when the suspected cause of stroke is the narrowing of this artery carrying blood to the brain.

  • An echocardiogram uses a doppler probe to look at how the heart is working. The probe is simply moved over the person’s chest. Sometimes an assessment of the heart from behind is required and in this case the probe is placed in a patient's food pipe (transoesophageal echocardiogram).

  • An X-ray will help determine the condition of the heart and lungs.


ECG (electrocardiogram)

This test is to determine if the patient has unusual heart rhythms. One particular type of heart rhythm that can be detected is called atrial fibrillation. This particular rhythm is a risk factor for stroke. During the first 24 - 72 hours it may be necessary to have continuous cardiac monitoring or be fitted with a portable form of monitoring called a 24-hour Holter.

Blood tests

Blood tests are necessary. For example: cholesterol, clotting, and blood sugar levels. These factors help determine why the stroke may have occurred. Blood tests can also indicate whether other organs are healthy and that any medication used is not causing harmful effects.

Swallow test

Difficulties with swallowing are experienced by over a third of those who suffer a stroke. This may increase the risk of food and drink getting into the windpipe and thus enter the lungs. We call this aspiration. Occurrence of this may cause chest infections and pneumonia.

The test itself is simple. The patient is asked by a nurse to swallow a few teaspoons of water and if they can do this successfully they are then asked to drink half a glass of water. If difficulty in swallowing is detected they will be referred to a speech and language therapist.

If needed, assistance will be given to patients with eating and drinking and at times it will be necessary to alter the consistency of foods and fluids to assist with swallowing issues. This may result in a puree diet or thickened fluids being offered to you. At times, to ensure nutritional needs are met, alternative methods of feeding are required (tube feeding).