Diagnosis of a stroke is currently based mostly on non-laboratory testing, including a physical and neurological exam and a variety of imaging tests. Researchers continue to try to find laboratory tests, such as stroke biomarkers, that could be used in stroke screening, diagnosis, treatment, and management.
Possible biomarkers that could be helpful in risk assessment include Lp-PLA2, N-methyl-D-aspartate neuroreceptors (NMDAR), and NT-proBNP, while candidates for stroke diagnosis include antibodies to NR2A/2B and metalloproteinases (MMPs). It may be that a panel of biomarkers would be most effective as a diagnostic or risk assessment tool. These tests are not yet widely available, and their uses are mainly in research studies at present.
Other laboratory tests may be ordered to evaluate a patient suspected of having had a stroke or to rule it out, including:
- Complete blood count (CBC)
- Prothrombin time (PT) and INR
- Partial thromboplastin time (PTT)
- Blood glucose
- Cholesterol, HDL, and LDL
Less commonly, one or more tests may be done in specific situations to identify conditions that contribute to risk of stroke. Some examples include:
- Antinuclear antibodies (ANA)
- Antiphospholipid antibodies (APL)
- Anticardiolipin antibodies (ACL)
- Lupus anticoagulant (LA)
- Blood culture
- Creatine kinase (CK)
- Protein C, Protein S
- Factor V Leiden
- Erythrocyte sedimentation rate (ESR)
- Hemoglobin electrophoresis
- Syphilis testing (VDRL, FTA, others)
- Toxicology screen (serum or urine)
Non-laboratory tests may include a CT scan or MRI of the brain to look for any injury as well as tests of electrical activity and blood flow in the brain.