What does the physical examination for stroke consist of?
EMTs will do a quick evaluation for symptoms of stroke before you get to the hospital, looking for slurred speech and any weakness in the face, arm, or leg on one side of the body. The examination will continue once you arrive at the hospital's emergency room.2 The doctor will check your pulse, temperature, and blood pressure. Your eyes will be examined for blood spots, a sign of bleeding. Using a stethoscope, the doctor will listen for an abnormal rhythm in your heart (atrial fibrillation) that can cause blood clots and for an abnormal whooshing sound in your neck (carotid bruit), a sign that plaque ( atherosclerosis, or hardening of the arteries) is interfering with blood flow to the brain. The doctor will also listen to your lungs and bowels for other abnormal sounds.
What do the results mean?
The most important question answered by the physical exam is if you are stable enough—meaning your medical condition is not rapidly changing—to have a CT scan to rule out bleeding (hemorrhage) in the brain, particularly if you have a severe headache or other signs of a bleeding stroke.
Additional imaging tests may be ordered if the physical exam shows you have certain conditions, such as a carotid bruit or atrial fibrillation. If you have a carotid bruit, the tests may include a carotid Doppler ultrasound or MRA to determine the amount of narrowing or blockage in your carotid arteries. If your doctor hears an irregular heart rhythm, he or she will order an ECG to examine your heart's rhythm more closely.
The physical exam and other blood tests can also diagnose other conditions, such as high blood pressure, that may affect your stroke treatment.
