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Diagnosing strokes by history and physical exam

Video transcript

if you've had a stroke or have had any warning signs of stroke such as sudden numbness on one side of your body you'd need to seek immediate medical attention so that a physician could diagnose a few things so first whether or not a stroke has occurred second how bad the stroke likely is and third what the underlying cause of that stroke could be and again a stroke is a medical emergency so you'd be seeking medical attention immediately so how is a stroke diagnosed well it's kind of done in a few steps the first step is for the doctor to get a detailed medical history so this means that you or maybe a family member if you're disoriented or unable to speak you or your family member would be able to explain to the doctor what happened to make you worried that a stroke might have occurred after that the doctor would go on to ask about the symptoms that you experienced so whether you had say an extreme headache which might indicate a hemorrhagic stroke or maybe you might have had some some sudden weakness in your limbs or in the muscles of your face or maybe you might have had problems with your vision or your balance you'd also be asked questions to check your memory and your speech and even your thinking because any or all of these could be affected in a stroke depending on which part of your brain has been injured and on top of all these symptom questions right you'd be asked about any risk factors that you might have for a developing stroke so you'd be asked about any hypertension that you might have been diagnosed with because we know that chronically high blood pressure right hypertension that predisposes you to particular types of strokes like hemorrhagic strokes and you'd also be asked about any heart conditions you might have like a trio fibrillation or or maybe a previous heart attack because those are both risk factors for stroke as well or you'd be asked about high cholesterol or if you smoked because both of those are some of the major risk factors for stroke as well so just keep in mind that the first step in diagnosing stroke is getting a really good picture of what's going on with the patient and that's done through this medical history this interview if you will the second step is for the physician to perform a full neurological exam on the patient so what in the world is that what does that involve well it's not really as scary as it sounds it's basically just a physical examination of a variety of your neurological functions and that's to look for any signs that a stroke has occurred so your motor skills right which is your movement ability and your sensation of both your upper and your lower limbs would be tested in a few different waves and then some of your special senses like your hearing and your vision would be tested as well you'd probably be asked to perform some fine motor tasks as well like like writing down a sentence with a pencil so a nice full checkup of your your movement ability in your sensation of your upper and lower limbs and based on your symptoms the doctor can often identify what part of the brain has been injured right so for example you might remember that symptoms on one side of the body suggests damage in the opposite hemisphere of the brain so if you had problems with your left arm for example that might suggest that something's going on in the right half of your brain and as another example problems with your balance and your walking might suggest damage to your cerebellum so depending on your symptoms and where they are it paints a pretty good picture of what part of your brain might have been injured in a stroke now as part of the exam the doctor will also check your pulse and your blood pressure and this is partly to look for any underlying heart conditions that might have caused the stroke so for example an irregular pulse might indicate atrial fibrillation which is one of those hard conditions where your heart doesn't keep a proper rhythm and that's a major stroke risk factor and besides your pulse in your blood pressure your reflexes might be checked as well to see if they were affected by the stroke and depending on what's going on with your reflexes particularly whether they're more responsive than usual or even absent just non-responsive that gives the doctor even more information about wearing the brain your stroke might have affected so by sort of gathering all this information by talking to you or your family member and by doing this neurological physical exam the doctor will be able to get a pretty good idea of what type of stroke might have happened where in the brain it might be and how severe it might be then after that further tests to confirm would be ordered so lab tests such as bloodwork and imaging tests such as brain scanning would be ordered to to further evaluate and diagnose the possible stroke