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Signs and Tests A history of the pattern of symptom development is important in the diagnosis of a stroke. Maximum neurologic deficits may be present at the beginning (onset) of the stroke, or symptoms may progress or fluctuate for the first day or two (stroke in evolution). Once there is no further deterioration, the stroke is considered a complete stroke. Examination may include neurologic, motor, and sensory examination to determine the specific neurologic deficits present, because they often correspond closely to the location of the injury to the brain. An examination may show changes in vision or visual fields, changes in reflexes including abnormal reflexes or abnormal extent of "normal" reflexes, abnormal eye movements, muscle weakness, decreased sensation, and other changes. A bruit (an abnormal sound heard with the stethoscope) may be heard over the carotid arteries of the neck. There may be signs of atrial fibrillation. Tests may be used to determine underlying disorders, the location and cause of the stroke, and to rule out other disorders that may cause the symptoms. a head CT or MRI of head may be used to rule out bleeding (hemorrhage) or other lesions and to define the location and extent of the stroke an ECG (electrocardiogram) may be used to determine underlying heart disorders an echocardiogram may be used if the cause is suspected to be cardiac embolus a carotid duplex (ultrasound) may be used if the cause is suspected to be carotid artery stenosis a cerebral (head) arteriography may be used if disorder involving the blood vessels is suspected This disease may also alter the results of the following tests: platelet aggregation test osmolality LDH isoenzymes LDH cytometric study CSF collection CPK isoenzymes BERA (brainstem evoked response audiometry) Treatment A stroke is an acute, serious condition. Immediate treatment is required. Treatment varies depending on the severity of symptoms. For virtually all strokes, there is a need for hospitalization, possibly including intensive care and life support. There is no known cure for a stroke. The treatment is essentially rehabilitation based on the symptoms presented. The treatment is also aimed at secondary prevention of future strokes. The recovery may occur as other areas of the brain take over functioning for the damaged areas. The goal of treatment is to prevent the spread (extension) of the stroke and to maximize the ability of the person to function.
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