Investigation and treatment

In order to look into the cause of your stroke or transient ischaemic attack (TIA), the following tests may be performed:

  • Blood tests, including checking for diabetes and high cholesterol.
  • A brain scan - either a CT or MRI.
  • An ECG (heart tracing) to measure the electrical activity of the heart and check for an irregular heart rhythm.
  • A carotid doppler scan (neck ultrasound) to assess for narrowing of the blood vessels in the neck, which if present, may require an operation to remove the narrowing and prevent further potential strokes.
  • An echocardiogram (heart ultrasound) to look at the heart valves and function of the heart.
  • A 24 hour heart monitor to look for evidence of an irregular heart beat over a 24 hour period.

Treatment

Lifestyle management

If you smoke we can give you advice on where to get support to help you successfully stop. We will also give you advice on healthy eating and weight control.

Blood thinning medication

If you have had a TIA, you may be treated with medication such as aspirin or clopidogrel. If you have a history of an irregular heart beat (atrial fibrillation) or we find evidence of this during your admission, we may recommend starting alternative medication.

Blood pressure lowering treatment

High blood pressure is a risk factor for TIAs and strokes. If your blood pressure is more than 140/80 we may discuss starting blood pressure lowering treatment. We will then ask your GP to monitor your blood pressure to ensure that it is sufficiently controlled.

Cholesterol lowering treatment

High cholesterol levels also contribute to strokes. You will usually be started on a cholesterol lowering tablet (a statin) unless you have a history of side effects. We aim for a fasting total cholesterol of less than 3.5 mmol/litre.

Carotid endarterectomy (surgery on a blocked carotid artery)

If your neck ultrasound scan shows you have a significant blockage to one of your carotid arteries, and it is felt that this has contributed to your symptoms, you will be referred to the vascular team for consideration for surgery to unblock the artery (carotid endarterectomy). The vascular surgery team will discuss the pros and cons of surgery with you and will advise if this may be a suitable option for you.

Driving

You will be advised not to drive for one month. This is in keeping with the DVLA guidelines. If you have no further symptoms you can then resume driving.

For further information please see the DVLA website.

Follow-up

You will be followed up at six weeks and six months by one of our community specialist stroke or TIA nurses, who will contact you with an appointment. 

If you think you have not been followed up, please contact the community stroke specialist nurse in your area. Please refer to meet the team pages for contact details.