Diagnosing Stroke

At Baptist Health, we work to quickly diagnose and treat stroke as soon as you get to our Emergency Department. Pinpointing a diagnosis and quick action are key to treating neurological disorders, including stroke. Our multi-disciplinary team of physicians and other clinical staff from the emergency department, radiology and neurology will work to quickly identify the type, location and severity of your stroke, and get you the treatment you need.

When you’re having a stroke, time is of the essence. It’s important for physicians to make a diagnosis quickly, so emergency treatment can begin and permanent damage and disability can be avoided.

Since different types of stroke require different treatment, we use a variety of diagnostic tests to quickly determine, and get you the right treatment.

Diagnostic tests for stroke may include:

  • CT scan, a type of x-ray that helps us look for blood in the brain
  • MRI scan, a scan test that gives us a detailed view of the soft brain tissue
  • Cerebral angiogram, an invasive procedure where a catheter is inserted into an artery
  • Electroencephalogram , measures the electrical activity in the brain
  • Myelogram, used to identify problems in the spinal cord or nerve roots

Some of these tests are performed by specialists in our radiology department using advanced diagnostic imaging equipment. We may also use other procedures for diagnosis.

Even if you haven’t had a stroke, you may be wondering if you’re at risk. Get proactive, by taking our stroke risk assessment.

CT scan for Neurological Conditions

A computed tomography, or “CT” scan, produces images of your brain to help your doctor look for problems, such as pooled blood.

This scan is often used to determine whether stroke symptoms are caused by a brain bleed or a clog in the vein or artery, so we can give you the correct treatment.

What is a CT Scan Exam Like?

Your CT scan will be performed by a certified technologist, who will explain the procedure and give you instructions.

During the scan, you’ll be positioned on a table, which slides into the CT scanner tube. While you’re in the scanner, you’ll hear the equipment hum as it produces the images.

The technologist will be able to see you at all times and be in constant communication with you via two-way microphones and monitors.

It’s important not to move during the exam, and you may be asked to hold your breath at times.

To make the structures of your brain or nervous system more visible on the CT image, we may need to use a special dye. The dye, also called a “contrast agent,” is usually injected into your arm with a small IV catheter for neurological scans.

The exam should take about 15 to 30 minutes with the dye, and about 15 minutes without.

If you do need dye, you may experience a temporary wave of nausea or metallic taste in the mouth after the injection. These and other side effects are common, but should still be reported to the technologist.

After your exam, a radiologist will look at the CT images and report the results to the doctor who ordered the scan.

For more information on CT tests and what you should know ahead of your appointment, please contact the Baptist Health Louisville Imaging and Diagnostics department.

MRI Scan for Neurological Conditions

A magnetic resonance imaging (MRI) scan may help your doctor better see the soft tissues and structures of your brain and spine.

The MRI machine uses a magnetic field and radio-frequency waves to create detailed pictures, which may make it easier to differentiate between your normal, healthy tissue and abnormalities, such as blood pooling in stroke patients.

What is an MRI Scan Exam Like?

Your exam will be performed by a certified technologist, who will explain the procedure and give you instructions.

During your exam, you’ll be asked to lie still on a table that slides into the MRI machine, which may make loud knocking sounds. Your technologist may be able to provide earplugs or headphones, so you can listen to music.

The technologist will be able to see you throughout the exam, you’ll be able to talk to him or her, and you may be given a call button in case you need immediate help.

To make the structures of your brain or nervous system more visible on the MRI image, we may need to use a special dye. The dye, also called a “contrast agent,” is usually injected into your arm with a small IV catheter for neurological scans.

The exam usually takes about 30 to 45 minutes per body part scanned, but it could vary.

Tell your doctor if you’re claustrophobic. He or she may prescribe an oral medication you can bring with you to your appointment, or help you arrange for an open MRI. Open MRI machines have a wider opening, and are available at some Baptist Health locations.

Things to Remember before your MRI

  • Arrive about 30 minutes before your exam is scheduled to begin, so you can check in
  • Tell your doctor if you are claustrophobic (have a fear of closed or tight spaces)
  • Bring a list of your current medications
  • Wear cotton clothing, with no metal such as zippers, hooks or buttons

For more information on MRI tests and what you should know ahead of your appointment, please contact the Baptist Health Louisville Imaging and Diagnostics department.

Cerebral Angiogram for Neurological Conditions

A cerebral angiogram creates a highly-detailed, clear picture of the clogs or ruptures in your brain to help your doctor diagnose and treat your condition.
 

Unlike MRI or CT scans, a cerebral angiogram is invasive, since it requires a catheter to be inserted into your body. As a result, we may be able to perform some treatment procedures during your exam, which may eliminate the need for surgery.

What is the Cerebral Angiogram Exam Like?

During the exam, you’ll be asked to lie still on an x-ray table and your head will be secured.

A thin tube, also called a “catheter,” will be inserted into one of your arteries and threaded through your blood vessels to the brain.

After the catheter is inserted, we’ll inject a special dye, also called a “contrast agent,” to make the structures of your brain or nervous system more visible on the cerebral angiogram image.

We’ll take a series of x-ray images as the dye spreads through your brain’s veins and arteries. These images will show whether any arteries have blockage, have ruptured or have aneurysms.

If the images show a blockage or rupture, it may be possible to perform some treatments during your exam, such as opening blocked arteries or inserting metal coils to repair an aneurysm. This may eliminate the need for surgery.

You may need several hours to recover from your exam before resuming your day-to-day activities. Notify your doctor if you notice any problems after your exam, such as slurred speech, impaired vision or numbness.

For more information on cerebral angiograms and what you should know ahead of your appointment, please contact the Baptist Health Louisville Imaging and Diagnostics department.

Electroencephalogram for Diagnosing Neurological Conditions

An electroencephalogram (EEG) is used to measure the electrical activity in your brain, and detect abnormalities.

EEGs are commonly used to diagnose epilepsy and seizure disorders, but may also be used for problems related to dementia, or in sleep studies for narcolepsy.

What is the Electroencephalogram Exam Like?

You’ll have several thin, metal electrode sensors attached to your scalp during the test. They will be connected by wires to a computer, which will monitor your brain’s electrical activity.

The electrical activity will be recorded as a wavy line, and will register any abnormalities.

Myelogram for Diagnosing Neurological Conditions

Myelogram is a diagnostic imaging exam used to spot problems in your spinal cord and nerve roots.

This exam is commonly used to diagnose herniated (“slipped”) discs, tumors, bone spurs, spinal stenosis and spinal malformations.

What is the Myelogram Exam Like?

During your exam, you’ll be asked to lie flat on an X-ray table.

Your radiologist will look at a fluoroscopy, a real-time moving image, of your spine to help find the best location to insert a needle with local anesthetic.

After the anesthetic, contrast dye will be injected to make the structures of your spine more visible on the X-ray. The table will be tilted so the dye can spread to different parts of the spine.

The spread of the dye will be monitored on the fluoroscopy.

After your myelogram, you may have a CT scan, which may more clearly image the structures of your spine.

A myelogram usually takes 30 to 60 minutes, but it may take another hour, if you also receive a CT scan.

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