When you are experiencing the symptoms of a stroke, an emergency diagnosis must be made as quickly as possible. Time is critical in preventing further damage to your brain and in reversing the damage already done. For this reason, you should get to an emergency room as quickly as possible.

After an initial review of your symptoms and medical history, a physical examination will focus on identifying the area of your brain that is being damaged. Your condition will be stabilized. An intravenous (IV) line will be started; blood and urine tests will be collected; and you will most likely have an examination of your head by computerized imaging—either an MRI or a CT scan .

The diagnosis evaluation includes:

• Neurological exams
• Blood and urine tests
• Imaging scans

If the type of stroke can be identified within three hours of the beginning of your symptoms, you may be treated with IV "clot-busting" drugs to prevent worsening and possibly restore blood flow to the involved areas of your brain. If it is within approximately 6 hours of the onset of your symptoms you may be treated with intra-arterial (IA) “clot busting” drugs.

Tests to determine the cause, location, and amount of damage include:

• CT scan—a type of x-ray that uses a computer to make pictures of structures inside the head
• MRI scan—a test that uses magnetic waves to make pictures of structures inside the head
• Arteriography (angiography)—a test that shows arteries in the brain after an injection of x-ray dye
• Magnetic resonance angiography (MRA)—a test that uses a dye to show the blood vessels in the brain
• CT angiography (CTA)—a test that uses a dye to show blood vessels using the CT machine
• Functional MRI—a test that shows brain activity by picking up signals from oxygenated blood in the brain
• Doppler ultrasound or carotid ultrasonography —a test that shows narrowing of the carotid arteries and vertebral arteries in the neck that supply the brain

Many strokes are due to heart problems, so be prepared to have heart function tests, as well. Possible tests include:

• Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
• Echocardiogram——a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart