What is the role of lab testing in the workup of ischemic stroke?

Updated: May 27, 2020
  • Author: Edward C Jauch, MD, MS, FAHA, FACEP; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Laboratory tests performed in the diagnosis and evaluation of ischemic stroke include the following:

  • Complete blood count (CBC): A baseline study that may reveal a cause for the stroke (eg, polycythemia, thrombocytosis, leukemia), provide evidence of concurrent illness, and ensure absence of thrombocytopenia when considering fibrinolytic therapy

  • Basic chemistry panel: A baseline study that may reveal a stroke mimic (eg, hypoglycemia, hyponatremia) or provide evidence of concurrent illness (eg, diabetes, renal insufficiency)

  • Coagulation studies: May reveal a coagulopathy and are useful when fibrinolytics or anticoagulants are to be used

  • Cardiac biomarkers: Important because of the association of cerebral vascular disease and coronary artery disease

  • Toxicology screening: May assist in identifying intoxicated patients with symptoms/behavior mimicking stroke syndromes or the use of sympathomimetics, which can cause hemorrhagic and ischemic strokes

  • Pregnancy testing: A urine pregnancy test should be obtained for all women of childbearing age with stroke symptoms; recombinant tissue-type plasminogen activator (rt-PA) is a pregnancy class C agent

See Workup for more detail.


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