STROKE-INVESTIGATIONS

SUMMARY

Standard investigations for all stroke patients:
1. Holter/ECG: to detect atrial fibrillation or other arrhythmias, heart blocks, ischemic changes
2. Echo: to detect cardiac source of emboli, valvular pathology, intramural thrombus, cardiac function
3. TOE: more sensitive to detection of valvular pathology and left atrial pathology
4. PFO: TTE with bubble study if age<60 and no other cause

5. Carotid ultrasound: to detect carotid stenosis
6. Blood tests: coagulation profile (prior to anticoagulation patient), lipid profile (to detect hyperlipidemia), electrolytes (to detect correctable electrolyte abnormalities and assess renal function), blood sugar, tests for thrombophilia (antiphospholipid, etc.), vasculitis, Fabry’sdisease

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].