To determine if you've had a stroke, your neurologist at HonorHealth will perform a complete physical and neurological exam. He or she will:
- Check for problems with vision, movement, sensation, reflexes, understanding and speaking. Your doctors and nurses will repeat this exam over time to see if your stroke is getting worse or improving.
- Check and assess your risk factors for stroke, such as high blood pressure, diabetes, high cholesterol, smoking, excessive alcohol use or drug use.
Your HonorHealth neurologist may also use one or more of the following tests to help determine the type, location and cause of the stroke and rule out other disorders:
- CT scan: Often done soon after stroke symptoms begin, a CT scan can help determine if and where a stroke has occurred or if there is bleeding in the brain.
- MRI: It helps reveal cellular changes in the brain.
- Electrocardiography: A tool that checks for irregular heartbeat, it can tell if the heart is experiencing ischemia (lack of oxygen in the blood). Quite often, a heart attack and stroke can happen at the same time. Some arrhythmias can also cause stroke, and this test will help find the best prevention medication.
- Magnetic resonance angiography or CT angiography: This technology uses a powerful magnetic field, radio waves and a computer to evaluate blood vessels and help identify abnormalities or diagnose atherosclerotic disease. The test may be done to check for abnormal blood vessels that may have caused the stroke.
- Echocardiogram: This ultrasound of the heart may be done to help determine if the stroke could have been caused by a blood clot that traveled from the heart.
- Carotid duplex: This ultrasound exam can show if narrowing of the neck arteries (carotid stenosis) led to the stroke.
- Angiogram: An angiogram of the head can reveal if a blood vessel is blocked or bleeding, and help your doctor decide if the artery can be reopened using a thin tube. The angiogram involves inserting a thin tube into a blood vessel in the leg and guiding it to blood vessels in the neck. After an injection of contrast dye, X-rays reveal all the blood vessels in the brain, pinpointing blockages or bleeding.
- Laboratory tests: Will include a complete blood count, a screen for diabetes, cholesterol levels and blood clotting tests.
- Spinal tap: Extracting spinal fluid may be done to see if it contains blood, indicating that an aneurysm has ruptured.
Treatment for stroke depends on the type of stroke you're suffering:
- For ischemic stroke, the treatment goal is to find and remove the blood clot and restore full blood flow to the brain as quickly as possible. If you arrive within a few hours of first experiencing stroke symptoms, you can receive a drug called tPA (tissue plasminogen activator). Administered by IV drip, tPA dissolves blood clots and reduces the severity of damage to the brain. Other blood-thinning medications may be used.
- For hemorrhagic stroke, treatment depends on the source and severity of bleeding. Medications are typically given to lower blood pressure and reduce swelling around brain tissue. If you've been taking blood-thinning medications, they will be discontinued immediately, and any available antidotes will be given. Three fully functioning neuro ICUs at HonorHealth John C. Lincoln, Deer Valley and Scottsdale Osborn medical centers give the patient the best possible chance of recovery after this type of a stroke.
- With an aneurysm — when a blood vessel ruptures — a specialist places a clip on the aneurysm to prevent further leaking of blood. This is done with endovascular surgery. It involves threading a catheter through a blood vessel in the groin to the brain and pushing delicate wires into the aneurysm site. The wires create a coil, and a blood clot forms around it, sealing off the blood vessel.
- Blockages in the carotid artery of the neck can be removed with carotid endarterectomy.
- Blockages within blood vessels of the brain can be removed by clot extractors. A catheter is maneuvered into the obstructed area of the artery. The clot extractor uses a retrievable stent, opening the artery and pulling out the blood clot.
Stroke recovery and rehabilitation
Each person's stroke recovery is different. Recovery and rehabilitation depend on the part of the brain affected by the stroke and the amount of tissue damaged. Harm to the right side of the brain may affect movement and sensation on the left side of the body. Damage to brain tissue on the left side may affect movement on the right side. This damage also may cause:
- Speech and language disorders
- Problems with breathing and swallowing
- Problems with balancing and hearing
- Loss of vision
- Loss of bladder or bowel function
The stroke rehabilitation process may take days or months. It begins with stabilizing you in the hospital. HonorHealth's neurology team strives to prevent the recurrence of stroke by carefully controlling risk factors such as high blood pressure and diabetes.
HonorHealth's physicians, nurses and therapists will collaborate to help you overcome new challenges, relearn lost skills and regain motor controls. While damaged brain cells cannot grow back, you can learn to adapt and gradually resume activities of daily living — such as walking, speaking, cooking and dressing.
Depending on complications you might have, the team of experts helping with your recovery could include:
- Rehabilitation doctor (physiatrist)
- Physical therapist
- Occupational therapist
- Recreational therapist
- Speech therapist
- Social worker
- Psychologist or psychiatrist
The goal of stroke rehabilitation is to help you recover as much of your independence and functioning as possible. Much of stroke rehabilitation, whether inpatient or outpatient, involves relearning skills you might have lost, such as walking or communicating.
Stroke support groups
If you've suffered a stroke or know someone who has, it can help to have people around you who know what you've been through. At HonorHealth's stroke support groups, patients, caregivers, family members and friends come together to share stroke prevention ideas, coping skills and information on new therapies. This friendly, caring group has a common bond: To live one day at a time and do the best we can every day.
Support groups meet:
- The first and third Monday of each month (except holidays) at the Cowden Center on HonorHealth's John C. Lincoln Medical Center campus, 9202 N. Second St. in Phoenix
- The first Wednesday of each month (except holidays) at Scottsdale Osborn Medical Center Outpatient Therapy Services Clinic, 3134 N. Civic Center Plaza in Scottsdale