Diagnosis

1. Symptoms of stroke
2. Imaging to confirm stroke and stroke type- should be obtained within 20 minutes of arriving to the emergency department 
   • Non-contrast computed tomography (CT) of the head 
     1. Widely available and quick to obtain 
        • Magnetic resonance imaging (MRI) may detect ischemia in cases of a TIA or minor ischemic stroke
        • In an acute setting an MRI is time consuming and a CT is easier to obtain and can be conducted faster
     2. Differentiate between an ischemic versus hemorrhagic stroke
        • CT may not detect a small/minor stroke
        • A normal CT result/reading in the setting of a minor stroke does not include nor exclude ischemia

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Differential diagnosis

• rule out other disease states that may mimic a stroke/symptoms of stroke 
• This includes the following:
  • Hypoglycemia 
  • This is required to be assessed. This will be further discussed in the treatment section below. 
  • Migraine (typically recurrent) 
  • Seizures
  • Tumors (history of diagnosis on imaging) 
  • Intoxication 
  • Infection 
  • Electrolyte imbalances (such as hyponatremia)