Signs and Tests

Maximum neurologic deficits may be present at the beginning (onset) of the stroke, or symptoms may progress or fluctuate for the first day or two (stroke in evolution). Once there is no further deterioration, the stroke is considered a complete stroke.

An examination may include neurologic, motor, and sensory testing to determine the specific deficits present. The examination may show changes in vision or visual fields, changes in reflexes including abnormal reflexes or abnormal extent of "normal" reflexes, abnormal eye movements, muscle weakness, decreased sensation, and other changes. A bruit, an abnormal sound heard with the stethoscope, may be heard over the carotid arteries of the neck. The blood pressure may be high. Horner's syndrome may occur, which involves a small pupil, drooping of one eyelid, lack of sweating on one side of the forehead, and a sunken appearance to one eye.

Tests (see also tests for stroke):

• a cerebral angiography reveals changes indicating carotid dissection
• a duplex/Doppler ultrasound can also detect dissection
• MRI or CT of the head to determine extent and location of stroke

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