Further diagnostics for stroke prophylaxis

After the stroke has been treated and the patient is no longer in danger of dying, the cause of the stroke is investigated further. This is important to prevent another stroke. This is because a stroke does not always come from the brain itself – contrary to what is thought – but is usually caused by cardiac arrhythmia or a narrowing of the cervical vessels.

An ultrasound examination of the cervical vessels (carotid Doppler, FKDS = color-coded Doppler sonography) as part of a stroke diagnosis makes sense because the blood circulation in the brain takes place via the cervical vessels. From the heart, the blood is ejected via the cervical vessels into the blood vessels supplying the brain.If, in the course of life, there is increased calcification in the area of the cervical vessels and thus also increasing occlusion of the cervical vessels, the blood flow to the brain also becomes increasingly less. From a certain degree of closure of the neck veins, the adequate blood supply to the brain is no longer guaranteed, so that a stroke can occur.

It is also advisable to have an ECG as part of stroke diagnosis, since certain cardiac arrhythmias increase the risk of a stroke. If atrial fibrillation of the heart is the primary cause, the risk of blood clots (so-called thrombi) forming in the area of the right atrium is significantly increased. These blood clots can come loose and then travel from the heart via the cervical vessels to the vessels supplying the brain and block them.

The occlusion of brain-supplying vessels then leads to a stroke. If atrial fibrillation is present, it is absolutely necessary to take blood-thinning medication to prevent the formation of such blood clots. In addition to an ECG, a swallow echo can also be performed.

For this purpose, a special ultrasound device (sonography device) is inserted through the mouth into the esophagus and from there an ultrasound of the heart is performed. The heart can be shown in its individual structures as well as the adjacent vessels. Thus, even blood clots in the heart, preferably in the right atrium or heart ear, can be visualized and proven.

If a stroke has occurred or if a stroke is suspected, the detection of such thrombi is a clear indication of a stroke due to an occlusion from a brain vessel by a blood clot. The EEG (electroencephalogram) is a measurement of electrical activity of nerve cells in the brain, also known as brain current measurement. An EEG can sometimes provide information about the function of the various brain regions, which can be useful in the context of a possible stroke. If a stroke is suspected or diagnosed, the EEG can be used to assess the area and extent of brain damage. In addition, disturbances in the EEG can indicate, for example, whether or not there is a tendency for epileptic seizures after a stroke has occurred.