Obligatory medical device diagnostics.
- Computed tomography/magnetic resonance imaging of the skull (cranial CT or.cCT/cranial MRI or cMRI) – for basic diagnosis.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – as a basic diagnostic tool to exclude cardiac arrhythmias (ECG recording over 72 hours captures about 92% of cases of atrial fibrillation).
- Doppler/duplex sonography (ultrasound examination: combination of a sonographic cross-sectional image (B-scan) and the Doppler sonography method; imaging method in medicine that can dynamically represent fluid flows (especially blood flow)) of the carotids (carotid arteries) – to assess the vessel wall conditions.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- CT/MR angiography or digital subtraction angiography (DSA; procedure for isolated imaging of vessels) – if underlying vascular anomalies are suspected.
- Transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE; ultrasound examination of the heart by means of an ultrasound probe inserted into the esophagus) – in cases of cardiac arrhythmias with suspicion of cardiac thrombi (blood clots in one of the inner chambers of the heart)
- Long-term ECG (ECG applied over 24 hours) – to exclude cardiac arrhythmias.
Further notes
- According to an observational study, without evidence of ischemia on MRI, the risk of apoplexy was not increased in the following 12 months; only in one-fifth of cases was the physician’s suspicion confirmed. Important predictors of ischemia detection (evidence of reduced blood flow) on MRI were:
- Male sex (odds ratio 2.03).
- Motor symptoms (OR 2.12)
- Persistent symptoms until medical examination (OR 1.97).
- Abnormal findings on initial neurologic examination (OR 1.71).
- Absence of an identical event in the anamnesis (medical history) (OR 1.87).
