Diagnostic

When clinical symptoms of a stroke occur, a patient should immediately be referred to a Stroke Unit.

 Stroke Unit is an integral part of a stroke patient’s journey, regardless of age, cause and severity of the stroke. This is a 7/7 and 24/24 specialized neurology unit dedicated to the management of these patients. A neurologist on call is permanently present, allowing for immediate management as soon as the patient arrives.

The clinical symptoms that are observed by the neurologist may include:

• Sudden onset of neurological deficits,
• Sudden headaches,
• An unexplained coma,
• Sudden alteration of consciousness.

After the physical and neurological examination to confirm the diagnosis of a stroke, it is necessary to determine as soon as possible the cause of this stroke, either ischemic or hemorrhagic, using a neuroimaging procedure:

• MRI (magnetic resonance imaging), is best option because of its high sensitivity to all types of disorders. The angiography can be performed simultaneously with the MRI to locate exactly the affected vessel or vessels.
• Computed tomography (CT) is the most common test that is initially performed. It is not the most sensitive test to more discrete and ischemic injuries, but it is usually more easily and more quickly available.

The image assessment through these procedures will guide the patient to the most appropriate monitoring and treatment.

There are now 135 Stroke Units in France that have proven their ability to manage stroke patients in emergency. Similar stroke management structures are available in many other countries.