19th July 2023

Investigation

Key initial investigations include full blood count, urea and electrolytes, glucose, clotting screen and group and save.

Urgent brain imaging with non-contrast CT should be performed to exclude intracerebral haemorrhage. In the very early stages of an ischaemic stroke, there may not be any visible CT changes; therefore, a normal CT scan does not exclude stroke. Further imaging with either CT-angiography or MR-angiography will be required if the patient is being considered for thrombectomy or if there is clinical suspicion of dissection.

Following a diagnosis of stroke, further investigations are carried out to identify the underlying cause. These may include serial ECGs, ECG Holter monitor, carotid imaging, echocardiogram, vasculitis screen and thrombophilia screen. Investigations should be targeted based on the clinical picture and the most likely differential diagnoses.