Symptoms:

The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not even be aware that he or she has had a stroke.

Symptoms usually develop suddenly and without warning. They may be episodic (occurring and then stopping) or they may slowly get worse over time.

Symptoms may include:

• Change in alertness (consciousness)
  • Coma
  • Lethargy
  • Sleepiness
  • Stupor
  • Unconsciousness
  • Withdrawn
• Difficulty speaking or understanding others
• Difficulty swallowing
• Difficulty writing or reading
• Headache
  • Occurs when lying flat
  • Wakes you up from sleep
  • Gets worse when you change positions or when you bend, strain, or cough
  • Starts suddenly
• Loss of coordination
• Loss of balance
• Movement changes, usually on only one side of the body
  • Difficulty moving any body part
  • Loss of fine motor skills
• Nausea or vomiting
• Seizure
• Sensation changes, usually on only one side of the body
  • Decreased sensation
  • Numbness or tingling
• Suddent confusion
• Weakness of any body part
• Vision changes
  • Decreased vision
  • Loss of all or part of vision

Signs and tests:

Knowing how the symptoms developed is important when it comes to diagnosing a stroke. Symptoms may be severe at the beginning of the stroke, or they may slowly get worse or occur off and on for the first day or two.

A neurological exam may suggest increased intracranial pressure or decreased brain function. The person's specific symptoms can help tell which part of the brain is affected.

An eye exam may show swelling of the optic nerve from pressure in the brain, or there may be changes in eye movement. Abnormal reflexes may be present.

The health care provider may hear an abnormal sound, called a "bruit," when using a stethoscope to listen to the carotid arteries in the neck.

Tests can help your doctor determine the type, location, and cause of the stroke and to rule out other disorders that may be responsible for the symptoms. Tests may include:

• Angiogram of the head to see which blood vessel is blocked or bleeding and help your doctor decide if the artery can be reopened using a thin tube
• Complete blood count (CBC)
• Bleeding time
• Blood clotting tests (Prothrombin time or partial thromboplastin time)
• Electrocardiogram (ECG) to diagnose underlying heart disorders
• Echocardiogram if the stroke may have been caused by a blood clot from the heart
• Carotid duplex (a type of ultrasound) if narrowing of the neck arteries (carotid stenosis) led to the stroke
• Head CT or head MRI or newer tests, called magnetic resonance angiography (MRA) or CT angiography, to determine the location and severity of the stroke and which blood vessel is blocked or bleeding
• Heart monitoring to determine if an irregular heart beat (such as atrial fibrillation) caused the stroke