Stroke, Part Two: A Patient Guide

By Jacqui O'Connell, RN

Diagnosing a stroke

Any type of stroke is considered a medical emergency and requires urgent medical assistance, because immediate treatment can make the difference between life and death. Your treatment will hopefully restore blood flow to the affected area of the brain, stabilize your condition and ensure that increased intracranial pressure (ICP) is prevented. Therefore, the initial diagnosis, ongoing assessment and treatment can play a vital role in the overall outcome of a stroke.

Before diagnosing a stroke, a physician will determine your complete medical history and risk, and perform a complete physical exam. Also, he or she will note the severity, frequency, pattern of symptom development and duration of symptoms. (For example, did the symptoms occur suddenly or gradually? Early or late in the day? And were the deficits most apparent at the onset of symptoms or did they develop gradually?) If you are unable to provide the physician with the fine details of your symptoms, it is important to have a family member or friend accompany you to the emergency room who can.

Knowing what to expect from a physical exam may help you feel more comfortable. During the physical exam, your vital signs will be taken and monitored closely. Your blood pressure will be measured in both a sitting and lying position, because many stroke patients will have an elevated blood pressure. Your doctor will use a stethoscope to listen for abnormal sounds in the carotid and peripheral arteries. He or she will also listen closely to your heart and lungs and assess your swallowing function (since impaired swallowing predisposes you to development of pneumonia). Your mental status will also be closely monitored to show changes in levels of consciousness (LOC) that may indicate ischemia (a decreased blood flow resulting in decreased oxygen flow) or increased ICP. An inadequate supply of oxygen can lead to increased ICP, so you may be given oxygen.

An electrocardiogram is used to monitor your current cardiac status and to determine if any cardiac conditions that might predispose to stroke are present (such as atrial fibrillation/flutter or an signs of an old heart attack).

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