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Diagnosis and Prognosis

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Diagnosis
In order to determine what treatment is appropriate, the cause of the stroke and the area(s) of the brain that are affected must be evaluated (Mayo Clinic, 2019). First, physical and neurological exams are conducted to determine how the potential stroke is affecting the nervous system (Mayo Clinic, 2019). Following this, one or more of the following diagnostic tests are conducted (Mayo Clinic, 2019):CT scans and MRI use radiation and large magnetic fields to create an image of the brain; allowing for the cause, location, and extent of brain injury to be viewed (American Heart Association, 2019). As shown in Figure 9, the appearance of the CT scan can determine whether the stroke was ischemic or hemorrhagic. Ischemic strokes appear dark compared to the rest of the brain, while hemorrhagic strokes appear bright. CT or MRI angiograms use a special dye injected into the veins to create an x-ray movie; allowing the blood vessels and the blood flow through them to be viewed (Mayo Clinic, 2019). Angiograms are often done in conjunction with a carotid ultrasound, which uses sound waves to produce images of the inside of the carotid arteries (supply blood to brain); they can detect plaque build-up and blocked blood flow (Mayo Clinic, 2019). As shown in Figure 10, a healthy artery (left) does not have any plaque build-up, leaving a large channel for blood flow. In an artery with atherosclerosis (right), plaque builds-up within the artery and the channel for blood flow decreases. Lastly, echo-cardiograms use sound waves to produce images of the heart to determine if heart problems caused the stroke (Mayo Clinic, 2019). 

Prognosis
In Canada, ~30% of all strokes result in death (Public Health Agency of Canada, 2017). Of those who survive, 25% live with minor disabilities, 40% live with severe disabilities, and the remaining 35% recover full independence (Public Health Agency of Canada, 2017). The recovery period can vary from weeks to years, with rehabilitation, on-going care, and emotional support aiding in the process (National Heart, Lung and Blood Institute, 2018).
 

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