Procedures

After a stroke, investigations and procedures provide your treating team with information about the type of stroke you have had, as well as what area of the brain has been damaged and how severely. Common investigations include:

Brain scans

Computer axial tomography (CAT or CT scan) and magnetic resonance imaging (MRI) take pictures of your brain to show areas of damage and swelling. Either a CT scan or MRI should be done within the first 24 hours after a stroke. This is to work out the type of stroke. They may be repeated later to see how much of the brain has been damaged by the stroke, or if you are getting worse.  

Heart tests

An electrocardiogram (ECG) is a test for abnormal heart rhythm or heart disease. This test is recommended for everyone after a stroke. Another heart test is an echocardiogram which is an ultrasound to check for a clot or enlargement of a chamber in your heart.

Other investigations that may be performed in hospital include a transcranial doppler, a cerebral angiogram and a carotid duplex.

A transcranial doppler (TCD) is an ultrasound that measures the speed of the blood flow in the arteries to help identify areas of slow blood flow in the brain. A cerebral angiogram is a catheter placed in artery and used to inject a dye. X-ray images are taken to show any blockages in blood flow in the brain. A carotid duplex or doppler is an ultrasound that looks at neck arteries to see if they are narrowed or partially blocked.

Thrombolysis

To minimise the damage caused by a stroke, some people may be suitable for a procedure called thrombolysis. Thrombolysis is the process where rt-PA is administered. rt-PA is a clot-busting drug that breaks down a blood clot to allow blood flow to return to the brain. rt-PA can only be given to you if you have had an ischaemic stroke. It must be given within a few hours after your stroke. rt-PA is not suitable for everyone. The stroke team will decide whether you are likely to benefit from rt-PA and will discuss this with you.

In some cases, your doctor may recommend a procedure called a carotid endarterectomy. This involves removing plaque from the carotid arteries that carry blood to the brain. Doing this improves blood flow to the brain and lowers the risk of blood clots or pieces of plaque breaking off and blocking blood flow.