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What can I expect during a stroke evaluation?

During the initial stroke evaluation, the single most important piece of information a physician will want is the time the symptoms started. Depending on how much time has passed since symptoms began, the doctor may have to rule out certain treatment options. Another important part of the physical examination process is assessing the neurological symptoms and signs (such as numbness or weakness on one side of your body) and the time frame in which they occurred. These are indispensable clues to the nature of the stroke and the type of blood vessel problem that caused it. The doctors -- typically an emergency team and a neurologist -- will take a careful medical history, asking about past events and any risk factors that suggest a stroke, such as a previous stroke or transient ischemic attack (TIA), diabetes, hypertension, cardiovascular disease, or neurological disorders. If you aren't able to answer these questions, the doctor will ask one of your relatives or close friends.

During the examination, the doctor will measure your blood pressure in both arms and listen to your heartbeat to check for carotid bruits, the abnormal rushing sounds made by blood flowing through a narrowed vessel. Hearing a bruit is strong evidence that you have a narrowed carotid artery. The doctor will also do a neurological examination to assess your brain functions, such as memory, motor skills, hearing, vision, touch, and the ability to read, write, and speak. As part of this neurological exam, you may be asked to bare your gums and stick out your tongue. The doctor may also test your hearing by making slight sounds next to each ear, and check your eyesight by asking you to read something or track a moving object using one eye at a time.

With these techniques, the doctor can home in on the general area of the brain that has been affected. Speech or language difficulties generally indicate a stroke on the left side of the brain. Impaired function on one side of the body signals damage to the opposite side of the brain. Problems with movement and balance usually mean trouble with the cerebellum.

Your medical and neurological history, along with the results of the physical and neurological exams, allow the doctor to make a preliminary diagnosis about the location and type of the stroke.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.